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Digestion  and  ©yspepsia 

A 

COMPLETE  EXPLANATION 

OF  THE 

PHYSIOLOGY  OF  THE  DIGESTIVE  PROCESSES, 

WITH  THE  SYMPTOMS  AND  TREATMENT  OF 

DYSPEPSIA 

*imD  OTHER 

DISORDERS  OF  THE  DIGESTIVE  ORGANS, 


ILLUSTRATED. 


BY  R.  T.  TKALL,  M.D., 


Author  of  "The  Hydropathic  Encyclopedia,'*  "Hygienic  Hand-book,"  "Thf 
True  Healing  Art,"  "The  Bath,  its  History  and  Uses," 
"  Hydropathic  Cook-book,  '  etc. 


New  York: 
FOWLER  &  WELLS  CO.,  PUBLISHERS, 

27  East  21st  Street. 


London: 
L.  N.  FOWLER  &  CO., 
7  Imperial  Arcade,  Ludgate  Circus. 


Entered  according  to  Act  of 
By  SAMUEL 
In  the  Office  of  the  Librarian 


Congress,  in  the  year  1873, 
R.  WELLS, 

of  Congress,  at  Washington. 


ORPHANS'  STEREOTYPE  FOUNDRY — CHURCH  CHARITY  FOUNDATION,  BROOKLYN. 


(j>4t*.33 


REMOTE  STORAGE 


PREFACE. 


THIS  work,  now  offered  to  the  public,  is  a  Summary  of  the 
data  which  I  have  been  collecting  for  more  than  a  quarter  of  a 
century,  with  regard  to  the  nature,  causes,  complications,  and 
proper  treatment  of  the  diseases  of  the  digestive  organs  ;  and 
an  experience  of  more  than  thirty  years,  during  which  time  I 
have  had  the  professional  management  of  several  thousands  of 
invalids  (besides  hundreds  which  I  have  treated  through  corres- 
pondence), a  large  proportion  of  whom  were  dyspeptics,  has 
convinced  me  that  the  theories  advanced  and  the  practice 
recommended  in  this  volume,  are  true  and  successful.  I  have 
only  to  add,  that  I  have  not  in  any  case  administered  medi- 
cine, but  have  relied  exclusively  on  Hygienic  agencies  as 
remedial  resources. 

R.  T.  T. 

Hygeian  Home.  i 
Florence  flights,  N.  J.  J 


702568 


CONTENTS. 


PART  I.-DIGESTION. 

Chapters  Page 

Preface   5 

Introduction   7 

I. — Nutrition   II 

II. — Insalivation   13 

III.  — The  Teeth   19 

IV.  — Deglutition   34 

V. — Chymification   35 

VI. — Chylification  43 

VII.  — Intestinal  Digestion   45 

VIII. — Absorption  of  the  Nutrient  Elements  56 

IX. — Aeration  of  the  Food  Elements   59 

Tobacco-using   64 

Tight  Lacing   68 

Position  and  Malposition   74 

I»AIiT  II.-DY8PEP8IA. 

X. — Nature  of  Dyspepsia   82 

XI. — Special  Causes  of  Dyspepsia   86 

XII. — Symptoms  of  Dyspepsia   94 

XIII.  — Dyspepsia  and  the  Cachexies  ,   1 10 

XIV.  — Principles  of  Treatment   114 

XV.— Food   115 

XVI. -Drink   120 

XVII.— Exercise   122 

XVIII.  -  Bathing   127 

XIX.— Clothing   132 

XX.— Sleep                                                                      .  136 

XXL— Ventilation   139 

XXII.— Light   143 

XX1IL— Temperature   144 

XXIV.— Mental  Influences   146 

XXV. —Occupation   149 

Appendix   155 


INTRODUCTION. 


We  are  a  nation  of  dyspeptics  ;  and  if  we  can  believe  the  evidences  of 
our  senses  and  the  testimony  of  physicians,  we  are  growing  worse  continually. 
Where  is  this  devitalizing  tendency  to  end  ?  There  are  writers  and  book- 
makers enough  on  this  subject,  but,  unfortunately,  our  anti-dyspeptic  litera- 
ture, like  the  remedy  it  recommends,  is  more  extensive  than  useful.  Many 
books  have  been  written  by  physicians,  regular  and  irregular,  to  advocate 
some  favorite  theory  or  hobby,  or  commend  some  plan  of  medication  in 
which  the  author  had  a  professional  or  pecuniary  interest.  And  a  still 
greater  number  of  both  have  flooded  the  country  with  no  other  motive  on 
the  part  of  their  proprietors,  than  to  enhance  the  sale  of  some  nostrum  in 
the  shape  of  some  "  Nervous  Antidote;"  "Blood  Food;"  "Bitters;" 
"Tonic  ;"  "  Hypophosphite,"  or  Anti-disease  Mixture.  All  of  the  litera- 
ture extant  calculated  to  instruct  the  people  in  the  proper  methods  for  pre- 
venting dyspepsia,  and  enabling  them  to  treat  themselves  when  sick,  with- 
out employing  the  doctor  or  patronizing  the  drug  shop,  is  exceedingly  lim- 
ited ;  and  even  that  little  has  an  extremely  limited  demand. 

The  public  mind  has  been  so  long  accustomed  to  rely  on  medicine  to 
remove  the  penalties  of  transgression,  when  persistent  disobedience  to  the 
laws  of  health  has  resulted  in  disease,  that  remedy  and  "  apothecary  stuff  " 
have  come  to  be  regarded  as  "one  and  inseparable."  It  is  a  delusion, 
however,  which  has  ruined  more  than  one  of  the  nations  of  the  earth,  and 
which  is  now  insidiously  but  not  the  less  surely  undermining  the  stamina 
of  the  American  people. 

"  Every  one  is  more  or  less  dyspeptic  now-a-days,"  is  a  common  saying  ; 
and  because  every  one  is  ailing  in  this  particular  manner,  it  seems  to  be  no- 
body's  business,  except  *hose  who  make  opportunity  of  misfortune.  It 
should  be  the  first  business  of  all.    It  should  be  the  first  business  of  the 


8 


INTRODUCTION. 


Christian,  the  philanthropist,  the  statesman,  the  legislator,  the  schoolteacher 
and  especially  the  physician  ;  for  a  dyspeptic  race  never  did  and  never  will 
permanently  maintain  any  progressive  government,  or  liberal  institutions, 
or  reformatory  measures,  if  indeed  they  can  do  anything  except  relapse 
into  barbarism  or  slavery,  as  have  the  nations  of  old. 

The  mortality  of  dyspepsia  makes  no  alarming  exhibit  in  our  "vital  ( 
statistics."  So  much  the  worse  ;  for  the  causes  of  constitutional  decine 
are  overlooked.  The  dyspeptic  person  has  an  ever  present  predisposition 
to  almost  all  forms  of  chronic  disease.  Indeed  the  dyspeptic  condition  is 
usually  regarded  as  a  mere  symptom  of  some  other  malady,  which  receives 
the  nosological  name,  and  to  which  the  death  is  accredited. 

In  the  mortuary  statistics  of  the  city  of  New  York,  for  the  last  year,  dys- 
pepsia is  not  mentioned  as  the  cause  of  the  death  of  a  single  one  of  the 
32,647  deaths.  But  the  fearful  record  appears  under  other  names.  The 
fact  that  the  increased  mortality  of  1872  over  that  of  187 1  reaches  the  enor- 
mous figures  of  5,500,  is  conclusive  that  something  is  operating  among  us 
like  a  continual  pestilence,  predisposing  to  a  multitude  of  diseases,  and 
rendering  the  system  powerless  to  overcome  their  special  causes. 

Dyspepsia  is  the  condition  that  almost  always  precedes  consumption  ;  in- 
deed, it  may  be  said  to  constitute  its  strongest  and  most  prevalent  predis- 
position. Dyspepsia  in  early  life,  and  consumption  in  middle  life,  stand 
to  each  other  in  the  relation  of  cause  and  consequence.  More  than  three- 
fourths,  and  probably  seven-eighths,  of  all  the  consumptives  in  adult  life, 
were  dyspeptics  in  youth. 

It  is  an  important  fact  that  nearly  all  affections  termed  scrofulous  and 
tuberculous  are  due  essentially  to  that  kind  of  Cachexia  whose  more  prom- 
inent manifestations  are  symptoms  of  indigestion.  Imperfect  nutrition  is 
the  very  essence  of  the  long  catalogue  of  chronic  diseases  which  are  said  to 
consist  in  a  "  depraved  habit  of  body,"  "  plethora,"  "anaemia,"  scrofula, 
scurvy,  and  other  morbid  diatheses. 

The  deaths  in  New  York,  in  1872,  of  scrofulous  and  tuberculous  affec- 
tions, are  put  down  at  6,023  ;  consumption  alone  gives  us  the  fearful  figures 
of  4,274.  Then  there  are  3,479  deaths  credited  to  that  mythical  phrase, 
"disorders  of  the  nervous  system,"  nearly  all  of  which  are  the  sequelae 
of  impaired  digestion.  We  have  here  a  record  of  nearly  fourteen  thousand 
deaths  attributable  to  diseases  intimately  connected  with  indigestion,  and 


INTRODUCTION. 


9 


which  could  never  have  existed,  certainly  not  to  a  fatal  degree,  without  its 
prior  existence.  But  if  we  were  to  pursue  the  analysis  through  ,  the  whole 
catalogue,  we  should  be  obliged  to  add  several  thousand  more  to  our  list  of 
deaths  essentially  due  to  dyspepsia.  Diseases  of  the  liver  and  kidneys, 
gastritis,  enteritis,  heart-diseases,  bronchitis,  many  cases  of  pneumonia, 
most  cases  of  apoplexy  and  paralysis,  and  a  majority  of  bowel  complaints- 
cholera,  diarrhoea,  dysentery,  colic,  constipation,  gall  stones,  intestinal 
concretions,  worms,  &c,  and  nine-tenths  of  the  cases  of  convulsions  in 
children,  have  their  predisposing  causes  and  all  their  dangers,  aside  from 
medical  treatment,  in  that  condition  of  defective  or  depraved  nutrition  to 
which  the  term  indigestion  is  applicable,  and  to  which  it  usually  is  applied 
in  the  generic  sense. 

If  we  take  New  York  as  the  basis  of  a  calculation  for  our  whole  country, 
the  result  is  frightful  ;  and  sufficiently  alarming  if  we  discount  fifty  per- 
cent, which  would  render  our  figuring  within  the  range  of  probability,  if 
not  of  certainty.  It  would  give  us  a  national  mortality  of  nearly  one  mil 
lion,  and  a  mortality  attributable  to  dyspepsia  of  nearly  half  a  million. 

One  thing  is  certain.  The  American  race  must  arrest  its  dyspeptic  ten- 
dency, or  die  out.  The  Irish,  the  German,  and  other  foreign  races,  of 
nerve,  stomachs  and  muscle,  and  of  more  ability  to  maintain  vitality  in 
themselves  and  transmit  it  to  offspring,  will  ere  long  possess  the  land,  un- 
less our  devitalizing  habits  are  reformed.  Already  some  of  our  older  States 
are  in  decadence  in  this  respect,  the  births  not  equalling  the  deaths.  And 
the  general  repugnance  of  American  wives  to  become  mothers  is  more 
attributable  to  the  general  dyspeptic  condition  which  unfits  them  to  b* 
mothers,  and  renders  maternity  painful  and  perilous,  than  to  all  other 
causes  combined. 


Arbor  Vit^. 


PART  I. 

DIGESTION*. 


CH  APTER  I. 
NUTRITION. 

Nutrition  is  tne  aggregate  of  all  the  organic  processes.  It 
may  be  distinguishable  into  digestion  and  assimilation.  Dis- 
integration is  the  separation  and  expulsion  of  the  debris,  or 
waste  matters  of  the  structures.  Digestion,  in  the  proper  sense 
of  the  word,  means  the  preparation  of  the  food  for  assimilation. 
It  comprehends  insalivation,  solution,  chymification,  chylifi- 
cation,  and  aeration.  A  brief  exposition  of  the  Physiology  of 
Nutrition,  in  the  order  of  the  digestive  processes,  will  the  better 
enable  us  to  understand  the  disorder  of  the  same  processes, 
which  constitutes  indigestion  or  dyspepsia.  And  to  make  the 
subject  more  intelligible  to  the  non-professional  reader,  let  us 
take  an  article  of  food,  an  apple,  if  you  please,  and  trace  it 
through  all  of  its  changes  from  the  tree  which  produces  it,  to 
the  tissue  which  assimilates  it. 

But,  in  order  to  understand  the  illustrations,  the  reader 
must  steadily  keep  in  mind  a  few  propositions  which  are  fun- 
damental, and  which,  except  the  last  three,  are  in  direct  an- 
tagonism with  the  doctrines  taught  in  the  text-books  of  our 
medical  colleges.    These  are  : 

i.  All  the  actions  and  changes  of  living  organisms  are  vital, 
not  chemical.  There  is  no  chemistry  in  living  structure.  Hence 
all  attempts  to  explain  the  problems  of  life  by  chemical  data 
must  forever  be  fallacious. 

II 


T2 


DIGESTION. 


2.  In  the  relations  between  dead  and  living  matter,  the  liv- 
ing acts  on  the  dead.  Hence  medicines  do  not  act  on  the 
living  organs  or  structure  in  virtue  of  inherent  or  elective  affin- 
ities, as  is  taught  in  the  works  on  Materia  Medica  and  Thera- 
peutics, but,  on  the  contrary,  are  resisted  and  rejected  by  the 
living  organs  and  structures.  Nor  do  poisons  act  on  the 
living  system,  as  is  taught  in  the  works  on  Toxicology  and 
Medical  Jurisprudence,  but  contrariwise,  the  living  system  acts 
in  relation  to  them. 

3.  Diseases  are  not  entities,  nor  processes  necessarily  inim- 
ical to  vitality,  nor  materials  nor  forces  at  war  with  the  vis 
medicatrix  naturce,  as  taught  in  the  works  on  Pathology,  but,  on 
the  contrary,  all  diseases  are  remedial  efforts,  whose  object  is  the 
defence  and  purification  of  the  vital  organism,  and  the  repara- 
tion of  the  deranged  structures. 

4.  Food,  drink,  air,  and  other  "  Hygienic  agencies,"  are  in 
no  sense  "  stimulants,"  as  taught  in  the  standard  works  on 
Dietetics  ;  nor  do  they  in  any  sense  act  on  or  do  anything  to 
the  living  organs,  as  taught  by  the  chemico-physiologists  *  but, 
on  the  contrary,  they  are  acted  on  by  living  structures. 

5.  Neither  medicines  nor  foods  possess  any  ' '  properties " 
which  they  impart  to  the  living  structures,  as  is  taught  in  all  of 
our  medical  schools,  with  a  single  exception  ;  but  on  the  con- 
trary, they  possess  inorganic  elements  and  organic  compounds 
which  are  rejected  or  appropriated  by  living  structures. 

6.  Poisons  are  those  agents  which  are  rejected  from  the  vital 
domain  (emetics,  cathartics,  tonics,  stimulants,  narcotics,  etc.), 
and  foods  are  those  substances  which  are  usable  in  the  forma- 
tion of  the  bodily  structures. 

7.  The  vegetable  kingdom  feeds  only  on  inorganic  or  cnem- 
ical  elements  in  a  state  of  solution,  transforming  them  into 
organic  products,  or  proximate  elements,  which  proximate 
elements,  as  combined  in  the  processes  of  vegetable  growth, 
constitute  food  for  animals  and  man. 

8.  Animals  and  men  cannot  feed  on  inorganic  or  chemical 
elements,  these  invariably  being  to  them  in  the  relation  of  poi; 


INSALIVATION. 


«3 


sons,  nor  can  any  organism,  except  that  of  the  vegetable, 
produce  food  of  any  kind.  Hence  animals  that  eat  other 
animals  can  only  get  such  aliment  as  they  have  received  from 
the  vegetable  kingdom. 


CHAPTER  II. 

INSALIVATION. 

The  first  act  of  digestion,  after  prehension,  or  taking  the 
food  into  the  mouth,  is  mastication.  The  object  of  mastication 
is  insalivation.  Every  particle  of  food  should  be  mingled  with 
saliva,  or  digestion  cannot  be  properly  performed.  And  here, 
in  the  outset,  we  see  one  of  the  most  prolific  sources  of  disease  in 
i 1  high  civilization" — imperfect  mastication.  As  meals  are 
presented  at  ordinary  tables,  and  in  all  hotels  and  boarding- 
houses  (except  a  few  of  those  which  are  called  Hygienic), 
very  few  dishes  are  in  a  condition  to  secure  mastication,  or  that 
even  admit  of  chewing  ;  while  the  few  which  might  be  masti- 
cated more  or  less,  are  hurried  into  the  stomach,  or  washed 
down  with  milk,  tea,  coffee,  water,  or  some  kind  of  alcohol- 
ized or  otherwise  medicated  fluid.  Those  who  would  have 
perfect  digestion  should  not  drink  anything  at  meals.  Drink- 
ing should  always  be  done  before,  after,  or  between  meals. 

Many  physicians,  and  some  Hygienists  of  loud  pretensions, 
are  very  fond  of  milk  themselves,  and  very  fond  of  recommend- 
ing it  as  a  leading  article  of  food  for  all  enfeebled  conditions  of 
the  digestive  organs — dyspepsia,  liver  complaints,  nervous  debil- 
ity, consumption,  etc. — and  even  in  fevers.  And  some  of 
them  seem  to  be  ' '  obsessed  "  with  the  chemico-physiological 
phantasy  that  milk,  like  fish,  is  a  peculiarly  phosphorizing  ali- 
ment, *nd  hence  marvellously  conducive  to  brain-tissue  and 
mental  power. 

Btif  such  advice  is  always  bad.  Many  patients  can  survive 
it,  and  many  will  improve  in  spite  of  it,  provided  the  sum  total 
of  all  their  other  habits  have  been  changed  for  the  beuer 


DIGESTION. 


Milk  cannot  be  among  the  better  articles  of  the  dietary  for 
adults  in  any  case.    Why  ?    They  do  not  masticate  it. 

It  is  true  that  milk,  when  pure  and  normally  produced  (I  do 
not  mean  the  commercial  article),  contains  all  the  nutrient 
elements  that  the  various  structures  require  ;  but,  unless  insa- 
livated, it  cannot  be  properly  elaborated  and  assimilated. 
How  well  it  can  be  used  depends,  of  course,  on  the  more  or 
less  healthy  condition  of  the  digestive  organs.  With  some  it 
seems  to  agree  very  well ;  and  the  same  may  be  said  of  much 
worse  things.  With  others  it  disagrees  very  decidedly,  and  in 
all  bad  cases  of  dyspepsia,  consumption,  or  biliousness,  it  in- 
variably aggravates.  It  is  also  especially  pernicious  in  all  of 
those  complicated  and  obscure  cases  of  indigestion  to  which 
the  phrase,  nervous  debility,  is  usually  applied,  as  I  have 
demonstrated  in  many  hundreds  of  cases. 

It  is  said  in  reply  to  these  objections  to  milk  as  an  article  of 
diet  for  persons  after  the  period  of  infancy,  that  nursing 
children,  and  the  young  of  all  mammalia  thrive  on  it,  that  they 
eat  almost  nothing  else  until  near  the  "  weaning-time. "  Ad- 
mitted. But  infants  take  it  "the  natural  way."  They  masti- 
cate it.  They  eat  it.  They  do  not  drink  it.  They  take  it  drop 
by  drop  and  insalivate  it  particle  by  particle,  as  it  flows  from 
the  mothers  breast,  or  from  the  nursing  bottle  when  this  is 
properly  adjusted.  If  the  milk  is  swallowed  too  fast,  as  will  be 
the  case  if  the  mother  uses  too  much  slop-food,  or  drinks 
largely  of  tea  or  coffee  at  her  meals,  or  if  the  nursing  bottle  has 
too  copious  a  delivery,  or  if  rapidly  fed  with  a  spoon,  the 
child  will  throw  it  up  ;  and  if  this  habit  is  long  persisted  in,  the 
milk  will  ferment  more  or  less,  the  child  have  a  sour  stomach, 
flatulence,  acrid  eructations,  canker  in  the  mouth,  etc.  In  a 
word,  "the  dear  little  fellow"  will  be  a  miserable  little  dyspep- 
tic. The  same  things  will  occur  if  the  child  inherits,  because 
of  the  erroneous  dietetic  habits  of  one  or  both  parents,  a  debili- 
tated or  imperfect  condition  of  the  digestive  organs,  rendering 
the  secretion  of  the  saliva  and  gastric  juice  deficient  in  quantity 
or  depraved  in  quality.  Obstinate  constipation,  chronic  diar- 
rhoea, erysipelatous  eruptions,  bilious  humors,  scalled  head,  etc., 


INSALIVATION. 


15 


are  among  the  affections  which  are  frequently  congenital  and  con- 
stitutional, because  of  the  dietetic  errors  of  those  whose  sacred 
duty  it  was  to  transmit  to  them  a  sound  organization — or  none. 

I  would  have  no  objection  to  pure  milk  as  an  article  of  food 
for  adults,  provided  they  masticate  it.  But  this  is  never  done. 
The  adult  always  drinks  it,  and  never  eats  it.  If  he  takes  it 
with  solid  food,  bread  and  milk,  for  example,  the  fluid  or  milk 
is  swallowed  (drunk)  before  the  bread  is  masticated  (eaten), 
or  the  whole  is  bolted  down  unmasticated  together.  It  would 
be  impossible,  or  at  the  least  very  awkward  for  ' '  children  of  a 
larger  growth, "  to  take  milk  as  infants  do.  What  young  lady 
or  gentleman  would  not  regard  it  as  a  huge  joke,  or  a  down- 
right insult  to  be  presented,  at  a  restaurant,  with  a  glass  of  milk 
and  a  straw  or  glass  tube  through  which  to  suck  it,  as  though 
it  were  a  i '  brandy  smasher, "  or  a  rumified  glass  of  soda  water  ? 
Nearly  all  adults  who  use  milk  at  meals,  sip  or  drink  it  as  they 
do  water  or  other  liquids. 

The  practical  rule  deducible  from  these  considerations  is, 
that  all  kinds  of  food  which  are  only  semi-solid,  or  composed 
of  solid  particles  diffused  in  water,  as  puddings,  stews,  mushes, 
gruels,  soups,  etc.,  should  always  be  taken  with  dry  bread, 
hard  cracker,  green  apples,  or  something  similar,  and  eaten 
very  slowly.  The  common  practice  is  the  reverse  ;  the  more 
fluid  dishes  are  spooned  down  as  rapidly  as  the  process  of  de- 
glutition can  be  performed,  and  the  solid  material,  more  or 
less  masticated,  hurried  after  it. 

The  disease  termed  Mumps  (Parotitis)  is  an  inflammation 
of  the  parotid  glands ;  and  when  both  are  affected  at  the  same 
time,  the  mouth  is  very  dry  ;  mastication  cannot  be  performed 
without  pain,  nor  can  the  "  sensible  properties  "  of  food  be 
recognized  as  in  the  normal  state.  If  strong  acids  are  then 
taken  into  the  mouth,  as  vinegar,  a  peculiar  benumbing  sen- 
sation is  experienced.  Those  who  use  tobacco,  alcohol,  or 
condiments  excessively,  have  a  condition  of  the  salivary 
glands  not  unlike  chronic  parotitis. 

We  will  the  better  appreciate  the  importance  of  the  insali- 


i6 


DIGESTION. 


vation  of  our  food  if  we  notice  the  ample  provision  that  nature 
has  made  to  ensure  it 

Fig.  i. 


In  Fig.  i.  all  of  the  salivary  glands  are  represented  in  their  natural  situation. 
1.  The  Parotid  gland,  extending  from  the  zygomatic  arch  of  the  cheek-bone  to  the 
angle  of  the  jaw  below.  2.  Its  duct,  termed  the  duct  of  Steno. 

3.  The  Sub-maxillary  gland.  4.  Its  duct.  5.  Sub-Lingual  gland. 

There  are  no  less  than  six  glands  appropriated  to  the  work 
of  secreting  from  the  blood  the  indispensable  digestive  fluid 
termed  saliva  ;  two  parotids,  situated  one  on  each  side  of  the 
head,  above  the  articulation  of  the  lower  jaw  and  near  the 
phrenological  organ  of  alimentiveness  ;  two  sublinguals  under 
the  tongue,  and  two  submaxillary,  between  the  others.  One 
of  each  of  these  glands  is  represented  in  the  illustration,  Fig.  i. 
\  The  location  of  the  salivary  glands  shows  their  intimate 
relation  to  mastication,  as  well  as  to  the  perception  or  recog- 
nition of  alimentary  substances.  The  proximity  of  the  two 
large  parotid  glands  to  the  organs  of  alimentiveness  explains 
why  the  ' '  mouth  waters  "  instantly  when  a  luscious  peach,  or 
a  basket  of  ripe  strawberries  (with  or  without  the  cream) 
comes  within  the  range  of  vision  ;  and  the  near  proximity  of 
the  other  salivary  glands  to  the  tip  of  the  tongue,  explains  why 
savory  substances  in  contact  with  that  organ,  so  readily  excite 
a  flow  of  saliva.    Again,  they  are  all  so  distributed  as  to  be 


INSALIVATION. 


excited  to  action  by  all  the  motions  of  the  tongue  and  jaws, 
when  in  the  act  of  mastication. 

That  the  salivary  secretion  is  sufficient  for  moistening  all 
food  that  it  is  proper  to  swallow,  is  proved  by  the  fact  that  no 
true  Hygienist  ever  experiences  any  thirst  while  eating ;  and 
no  one  who  has  a  normal  secretion  of  saliva,  and  who  tho- 
roughly  masticates  his  food,  will  ever  desire  to  drink  at  meals, 
provided  the  food  is  of  proper  material,  properly  cooked,  and 
not  improperly  seasoned.  It  is  true,  however,  that  high 
seasoning  of  all  kinds,  all  indigestible  admixtures,  and  all 
thirst-provoking  condiments,  necessitate  a  corresponding  degree 
of  water-drinking  while  eating.  But  this  is  only  on  the  prin- 
ciple of  the  lesser  of  two  evils. 

Fig.  2. 

The  provision  for  moistening  and 
insalivating  the  milk  on  which  chil- 
dren may  properly  subsist,  is  well 
shown  in  Fig.  2,  which  is  a  repre- 
sentative of  a  single  lobule  of  the 
parotid  gland  of  an  infant,  inject- 
ed with  mercury,  and  magnified 
fifty  diameters. 

Lobule  of  Parotid  Gland. 

One  of  the  great  and  increasing  evils  of  imperfect  mastication 
is  decaying  teeth.  It  is  a  law  of  all  vital  organisms  that  every 
structure  or  part  must  do  its  own  work  or  die.  If  a  hand  or 
an  arm  was  not  exercised  it  would  soon  perish.  Every  organ 
and  structure  pertaining  to  individual  life,  that  is  not  duly  ex- 
ercised, will  be  correspondingly  enfeebled.  Do  we  not  have  a 
sufficient,  as  well  as  a  sad  illustration  of  this  subject  in  the  tens 
of  thousands  of  dentists  ;  in  several  dental  colleges,  and  in  the 
immense  establishment  in  Philadelphia  for  the  manufacture  of 
artificial  teeth,  to  say  nothing  of  the  instruments  for  pulling  the 
rotting  teeth  out,  which  are  a  part  of  every  country  physician's 
outfit  ? 

In  a  majority  of  cases,  the  teeth  of  our  fast-living  Americans 
begin  to  decay  in  childhood.  A  young  lady  or  gentleman 
with  a  sound  set  of  teeth  is  an  exception  to  the  general  rule.  In 


i-8 


DIGESTION. 


thousands  of  instances  the  young  man  or  young  woman  needs 
a  set  of  artificial  teeth  before  he  or  she  is  ready  for  the  mar- 
riage relation.  And  if  both  parents  are  teethless  in  early  life, 
the  prospectus  dentatus  is  bad  for  the  rising  generation. 

If  the  teeth  were  properly  treated  they  would  never  decay. 
There  is  no  more  reason,  except  abuse,  why  the  teeth  should 
ulcerate  or  become  loose,  than  there  is  for  the  fingers  or  toes, 
or  the  ears  or  nose,  to  rot  and  fall  ofT.  The  teeth  are  the 
densest,  firmest  of  all  organic  structures,  and  should  be  the 
very  last,  instead  of  the  first,  to  decay. 

Domestic  animals  that  are  permitted  to  live  normally  never 
have  decaying  teeth.  No  matter  to  what  age  the  animal  lives, 
its  teeth  will  be  found  perfect  in  the  skeleton.  And  such  would 
be  the  case  with  every  human  being  if  the  teeth  were  not 
abused  by  non-use. 

It  ought  to  be  known  to  all,  as  it  is  known  to  those  who 
have  lost  their  teeth,  or  a  part  of  them,  that  a  whole  set  of 
sound  teeth  is  as  essential  to  comfort  as  it  is  to  health.  Nothing 
but  thorough  mastication,  and  complete  insalivation  can  enable 
one  fully  to  realize  the  properties  of  food.  All  proper  food  is 
pleasant  to  the  unperverted  taste,  and  the  palate  relishes  it  with 
a  zest  proportioned  to  its  own  integrity,  and  the  fineness  to 
which  chewing  reduces  it  into  molecular  particles.  Those  whose 
teeth  are  too  tender  to  masticate  solid  food  well,  or  have  not 
teeth  enough  remaining  to  do  it,  have  little  idea  of  the  taste  of 
an  apple,  a  potato,  or  even  a  piece  of  bread,  made  of  nothing 
but  wheat-meal  and  water.  They  require  salt,  vinegar,  pep- 
per, sugar,  butter,  or  something  else,  to  make  their  victuals 
"  taste  good."  But  no  amount  of  salines,  acids,  or  pungents 
can  render  it  so  delicious  and  satisfactory  as  natural  appetite 
and  proper  mastication  ;  nor  is  there  any  remedy  for  decaying 
teeth,  rotting  jaws,  bleeding  gums,  and  tartareous  excrescences, 
except  exercising  the  teeth  in  mastication. 

This  whole  subject  is  so  well  explained  and  illustrated  in  the 
Science  of  Health  for  August,  1872,  that,  with  the  permission  of 
the  publisher,  I  transcribe  the  entire  article 


THE  TEETH. 


CHAPTER  III.- — THE  TEETH  THEIR  USE  AND  CARE. 

Persons  who  have  any  pretensions  to  culture  and  refinement, 
regard  the  teeth  as  ornamental,  as  well  as  useful.  Before 


Fig.  3. — Complete  Set  of  Permanent  Teeth,  Showing  the  Nervous  Connections. 
In  this  illustration  the  bony  matter  has  been  carefully  cut  away  to  show  the  roots  of 
the  teeth  and  the  nerves  which  connect  them  with  the  brain. 

the  age  of  dentistry,  the  loss  of  a  tooth  by  decay  was  a  life-long 
misfortune.  Now,,  if  one  or  more  of  the  teeth  decay  or  by 
accident  are  broken  and  lost,  skilful  dentistry  supplies  by  arti- 
ficial means  those  which  match  the  original,  and  the  mouth  is 
kept  shapely  and  beautiful. 

Within  the  last  thirty  years,  the  science  and  art  of  dentistry 
has  made  very  great  progress.  Not  only  can  the  teeth  be 
treated  in  such  a  way  as  generally  to  preserve  them,  but  when 
they  commence  to  decay,  the  cavities  can  be  so  prepared  and 
filled  that  they  last  or  promise  to  last  a  lifetime  ;  whereas,  half 
a  century  ago,  decay  once  commencing  would  go  on,  causing 
intense  suffering  to  the  patient  and  an  early  loss  of  the  tooth. 

We  often  regret  to  see  persons  with  excellent  sets  of  teeth 
permit  them  to  remain  without  being  cleaned,  the  particles  of 


20 


DIGESTION. 


food  being  allowed  to  lodge  between  them  and  decay,  creating 
corrosive  acid,  which  destroys  the  enamel,  besides  greatly  de- 
praving the  odor  of  the  mouth. 

Every  person,  after  eating,  should  carefully  clean  the  teeth 
,  from  all  particles  of  food  with  a  quill  or  wood  pick,  and  then, 


Fig.  4. — Diseased  Teeth. 


Fig.  4 — Represents  the  jaws,  with  several  of  the  teeth  in  a  diseased  state.  Some 
portions  of  the  bony  matter  have  been  removed  in  order  to  exhibit  the  parts  affected. 
All  the  teeth  which  are  numbered,  except  No.  3,  which  is  entirely  sound,  are  carious, 
the  disease  having  penetrated  to  the  nerve.  Nos.  1,  4  and  7  show  the  jaw  and  teeth  in 
an  early  stage  of  disease.  Nos.  2,  5,  6,  8  and  9  are  ulcerated  at  the  roots.  Nos.  2,  5  and 
9  having  the  bony  matter  removed  to  show  the  ulceration  at  the  roots.  No.  5  shows 
the  ulcer  in  an  early  stage 


THE  TEETH. 


21 


with  water,  not  very  cold,  and  a  brush,  clean  them  carefully. 
In  this  way  many  a  set  of  teeth  could  be  kept  sound  and  hand- 
some through  life,  which  by  being  neglected  become  diseased 
and  decay  early.  Some  people  pick  the  teeth  with  a  penknife 
or  with  a  pin,  which  we  think  an  erroneous  practice.  The 
use  of  hot  drinks,  and  on  the  contrary,  ice-water  in  hot  weather, 
tends  to  the  decay  of  the  teeth,  because  it  produces  a  fever, 
and  sudden  changes  in  the  system,  which  seriously  affect 
them. 

Disease  of  the  teeth  appears  in  several  forms.  One  is  by 
caries  or  decay  from  the  surface.  Another  is  by  ulceration  at 
the  root,  and  a  third  is  by  tartar,  which  displaces  the  gum  and 
leads  to  the  decay  or  absorption  of  the  bony  matter  constituting 
the  sockets  of  the  teeth,  called  alveolar  process. 

The  remedy  for  tartar  is  to  have  a  skilful  dentist  remove 
it  as  soon  as  it  is  observed.  Indeed  an  examination  should 
be  made  by  him  occasionally  to  detect  its  presence.  Proper 
care  of  the  teeth  by  the  use  of  a  brush  after  every  meal  would 
generally  prevent  all  accumulation  of  tartar. 

These  conditions  we  illustrate  by  means  of  several  en- 
gravings. 

The  Indians  are  proverbial  for  their  good  teeth.  We  have 
examined  many  Indian  skulls  and  have  frequently  found  the 
teeth  worn  down  to  the  gums  with  not  a  speck  or  decayed  spot 
to  be  found  on  them.  Besides,  we  do  not  find  on  Indian 
teeth  tartar,  or  salivary  calculus,  as  is  too  often  the  case  with 
civilized  men's.  There  may  be  many  reasons  why  the  teeth  of 
) Indians  are  in  better  condition  than  the  white  mans.  The 
chief  one  perhaps  is,  that  they  give  their  teeth  ample  exercise. 
If  a  cow  is  fed  on  food  that  requires  no  mastication,  her  teeth 
become  decayed.  If  she  crops  the  grass  with  her  incisors, 
and  grinds  it  with  the  molars,  they  will  last  her  life-time  in  good 
condition;  but  let  her  be  put  into  a  stable  and  fed  on  still-slops, 
and  the  teeth  at  once  begin  to  decay,  as  also  the  bony  structure 
in  which  they  stand.  The  Indian  eats  parched  corn.  Having 
no  grist  mill,  he  grinds  his  food  with  his  teeth,  and  the  result 


22 


DIGESTION. 


is,  every  tooth  is  exercised.  If  we  eat  porridge,  broth,  stews, 
and  everything  else  cooked  softly,  and  get  no  exercise  for  the 
teeth,  they  become  to  us  almost  useless  ;  the  gums  become 
unhealthy,  the  teeth  decay,  and  give  us  a  world  of  trouble. 

Moreover  the  Indian  sleeps  with  his  mouth  shut,  breathes 
through  his  nostrils,  and  does  not  draw  the  cold  air  rapidly  over 
his  teeth.  This  is  true  of  all  animals.  The  canine  and  feline 
tribes,  that  pant  when  they  exercise  violently,  open  their 
mouths  and  breathe  through  the  mouth  ;  but  they  sleep  with 
their  mouths  shut.  White  men  sometimes  breathe  the  live- 
long night  chiefly  through  the  mouth.  The  celebrated  Mr. 
Catlin,  who  writes  on  Indian  habits,  attributes  bad  teeth  to  the 
white  man,  in  consequences  of  sleeping  with  his  mouth  open. 


Fig.  5.— Complete  Set  of  Infant  Teeth  at  Four  Years. 


Always  beware  of  using  scouring  material  on  the  teeth.  A 
little  fine  soap  on  the  tooth  brush,  to  make  a  pleasant  lather 
in  the  mouth,  is  believed  to  be  favorable  to  the  health  of  both 
mouth  and  teeth.  One  half  of  the  tooth-powder  have  acids  in 
them  which  injures  the  enamel  of  the  teeth.  Any  gritty  sub- 
stance which  tends  to  wear  off  the  enamel  is  bad. 

In  cities,  quack  peddlers  of  tooth-powders  may  be  found  at 


INSALIVATION. 


23 


the  corners  of  the  streets.  They  will  get  some  dirty  boy's 
mouth  open  and  with  strong  acid  make  his  teeth  shine  like 
ivory.  This  they  do  as  an  advertisement.  We  never  fail  on 
seeing  a  crowd  of  ignoramuses  gathered  around  such  a  quack 
to  speak  frankly  to  them,  and  advise  them  to  avoid  it  alto- 
gether. One  of  these  men  once  overheard  our  remark,  and 
said  "What  is  it  to  you?"  Our  reply  was,  "We  wouldn't 
put  such  acid  on  our  teeth  for  five  hundred  dollars."  His 
crowd  of  customers  vanished. 


Fig.  6. — Teeth  of  a  Cow  Fed  on  Natural  Food. 

Having  exhibited  the  anatomical  situation  of  a  complete 
set  of  permanent  teeth,  showing  their  nervous  connections, 
and  also  a  permanent  set  of  teeth  in  a  condition  of  disease  in 
various  stages,  we  come  now  to  consider  infantile  teeth,  and 
introduce  an  engraving  for  that  purpose.  The  bony  structure 
is  cut  away  on  the  jaws  to  show  the  roots  of  the  milk  teeth,  as 
they  are  called,  and  also  to  show  the  ultimate  teeth  or  the 
permanent  set  behind  the  milk  teeth. 

Before  birth  the  teeth  are  organized  rudimentally,  two  sets 
of  them,  one  above  the  other  ;  and  at  birth,  existing  in  the 
jaw  entirely  below  its  service,  there  is  a  set  of  teeth,  and  under 
this  set  there  is  a  little  sack,  which  is  to  be,  when  developed, 
a  permanent  tooth. 

In  the  engraving  one  half  of  twenty  teeth  are  represented. 


24 


DIGESTION. 


In  the  adult  mouth  there  are  thirty-two  teeth.  In  the  rear  of  the 
mouth  of  this  engraving  there  will  be  seen  the  rudiments  of  the 
permanent  teeth,  over  which  no  milk  teeth  are  developed.  In 
the  child's  mouth  then  there  are  twenty  teeth,  and  in  the  adult 
mouth  thirty-two,  including  the  wisdom  teeth,  which  come 
late,  at  from  twenty  to  fifty  years  of  age. 


Fig.  7.— Jaw  of  a  Cow  Fed  on  Hot  Still-Slops. 


The  infantile  teeth  are  small,  being  adapted  to  the  size  of 
the  jaw.  When  the  child's  age  advances  these  teeth  separate, 
the  jaw  grows  and  the  teeth  are  rendered  further  apart.  If  the 
teeth  are  not  extracted  soon  enough,  the  permanent  teeth 
sometimes  push  out  at  the  side.  This  often  happens  in  the 
case  of  the  eye-tooth ;  but  generally  the  teeth  are  lost  one 
after  another,  first  on  the  lower  jaw ;  the  jaw  expands  and  the 
cavity  of  the  mouth  increases  so  as  to  make  sufficient  room  for 
the  large  permanent  teeth. 

The  process  of  cutting  teeth  is  not  an  unnatural  one,  and 
ought  not  to  be  painful  or  dangerous.  In  the  present  state  of 
things,  however,  children  often  suffer  severely  from  it,  and  not 
unfrequently  life  is  destroyed  in  this  way.  This,  of  course,  is 
induced  by  irritation  and  feverish  excitement,  which  is  con- 
nected with  the  brain  by  means  of  the  nerves  of  the  teeth;  the 
same  amount  of  pain  might  be  sustained  by  the  patient  without 
injury,  if  related  to  the  foot  or  hand  and  farther  away  from  the 
brain. 

The  bad  habit  of  feeding  children  cake,  sugar  and  candy, 


INSALIVATION. 


25 


Fig.  8.— Tartar  on  Foul  Teeth  Tartar  Removed 


is  often  the  cause  which  tends  to  produce  much  trouble  relative 
to  the  teeth,  especially  early  decay,  which  is  at  present  so  com- 
mon. Our  artificial  modes  of  living  greatly  destroy  the  natural 
order  of  development  in  children,  hence  it  is  supposed  that  the 
trouble  with  the  teeth  is  the  result  of  ages  of  wrong  courses  of 
living.  The  death  of  one  half  of  all  the  children  that  are  born 
before  they  come  to  maturity  is  a  sad  commentary  on  the  crea- 
tive wisdom  that  established  the  natural  laws  and  punishes  the 
bad  habits  and  usages  of  civilized  society.  Nature  is  per- 
fect. God  the  Creator  is  all-wise  and  beneficent.  If  we  were 
but  wise  enough  and  good  enough  to  obey  the  laws  of  o*ur 
being,  this  great  mortality  of  children,  this  falling  off  of  human 
fruit  before  it  is  ripe,  would  be  done  away  with.  Mr.  Catlin 
asserts  that  nearly  all  the  infants  among  the  Indians,  unless 
they  died  of  accident,  came  to  maturity.  Though  he  saw  as 
many  as  four  thousand  Indian  skulls  in  a  depository  of  the 
dead,  there  was  not  an  infant's  skull  among  them.  The  death 
of  infants  and  children  was  so  rare,  that  the  oldest  inhabitants 
had  to  study  to  recall  the  death  of  children,  except  of  accident. 
But  our  children  inherit,  with  the  abuses  of  civilization,  bad 
conditions  of  the  teeth  generally  from  parents  who  have  lived 
in  an  abnormal  way  ;  hence  the  great  trouble  with  cutting  the 
teeth,  and  with  their  early  decay  after  they  are  cut. 

A  full  set  of  false  teeth,  in  the  upper  jaw  at  least,  is  very  com- 
mon among  women  of  twenty-five  and  among  men  of  thirty- 
five  in  our  own  country  to-day.  Occasionally  we  find  one  of 
the  old  stock  who  retains  a  healthy  and  vigorous  set  of  teeth 
until  he  is  seventy  years  old.  without  a  speck  of  decay,  with 
the  ranks  all  full.    This  law  of  temperance  and  health,  0? 


26 


DIGESTION. 


sound  constitution  and  sound  teeth  with  long  life,  pertains  to 
•he  animal  kingdom  as  well  as  to  men. 

The  cow's  jaw,  (Fig.  6,)  shows  every  tooth  in  its  place  and 
jrder,  with  a  fine  enamel,  adapted  to  do  the  work  for  which 
they  are  designed  ;  and  when  these  teeth  are  used  in  the  natu- 
ral way  they  are  healthy,  and  we  may  safely  conclude  the  ani- 
mal is  throughout  in  like  healthy  condition.  But  when  we 
turn  to  the  under  jaw  of  the  cow  that  has  been  fed  on  warm 
still-slops  and  kept  housed  up — even  as  women  and  children 
often  are- — secluded  from  wholesome  air,  we  find  the  teeth  de- 
cayed and  the  bone  of  the  jaw  unhealthy,  and  we  have  a  right 
to  infer  that  the  whole  animal  is  in  a  similar  unhealthy  condi- 
tion. 

The  illustrations  of  tartar  which  we  present,  show  a  very 
common  neglect  in  taking  care  of  the  teeth,  and  though  the 
teeth  themselves  may  not  be  decayed,  the  bony  socket  which 
contains  them  decays,  and  sometimes  the  teeth,  lacking  sup- 
port, fall  out  and  are  lost. 

One  of  the  best  evidences  of  good  culture  and  proper  care  of 
one's  self,  is  a  tidy  mouth  and  nicely  kept  teeth.  Every  reader 
knows  some  person  who,  when  he  laughs,  presents  teeth  that  are 
covered  with  tartar,  or  blackened  by  smoking,  and  whose 
mouth  is  a  disgust  to  every  beholder.  Such  people  should  go 
to  a  mirror,  where  they  can  take  a  view  of  their  open  sepulchre, 
full  of  dead  or  unclean  bones. 


fhe  lowest  forms  of  animal  life  have  the  simplest  digestive 
fct*aratus,  and  subsist  on  such  kinds  of  food  as  require  little 
elaboration.  The  very  lowest  animals  that  we  can  trace  seem 
to  be  all  stomach,  all  the  processes  of  digestion  being  performed 
In  a  single  canal  or  cavity.  No  animal  ever  manifests  two 
vfgans  or  structures,  or  parts,  without  one  of  them  being  ana- 
logous to  a  stomach.  The  monera,  the  lowest  form  of  animal 
life  yet  recognized,  has,  apparently,  no  organs,  parts  nor  struc- 
tures. When  it  needs  food  it  projects  an  instrument  and  takes 
it  into  its  substance.  Yet  it  has  a  digestive  apparatus,  or  it 
would  not  live,  develop,  grow,  nor  divide  into  parts,  nor  differ- 


INSALIVATION. 


27 


ential  into  organs.  The  digestive  organs  of  fishes  and  reptiles 
are  comparatively  simple.  Birds  macerate  the  grains  and  seeds 
in  their  crops,  and  then  masticate  them  in  the  stomach.  The 
gizzard,  a  tough  muscular  substance,  lined  with  an  exceedingly 
dense  membrane,  capable  of  grinding  stones,  metals,  and  even 
glass  to  impalpable  powder,  performs  the  office  of  teeth. 

In  the  carnivorous  quadrupeds  the  stomach  is  much  smaller 
and  the  alimentary  canal  much  shorter  than  in  the  herbivorous, 
while  the  omnivora  have  an  intermediate  size  of  stomach  and 
length  of  intestines.  The  lower  jaw  of  the  carnivora  has 
only  the  up-and-down,  or  cutting  motion,  while  the  teeth  are 
adapted  to  tearing  the  flesh  on  which  they  subsist,  as  seen  in 
the  cut,  Fig.  9. 

Fig.  9. 

In  the  omni- 
vora, of  which 
the  hog  is  un- 
fortunately our 
most  familiar 
example,  the 
back  teeth  have 
a  close  resem- 
blance to  those 

JAWS  AND  TEETH  OF  A  PANTHER. 

of  herbivorous  animals,  while  the  front  teeth  exactly  re- 
semble the  tearing  and  dagger-like  teeth  of  the  carnivora,  as 
represented  in  the  cut,  Fig.  10. 


Fig.  10. 


UNDER  JAW  AND  TEETH  OF  THE  HOG. 


28 


DIGESTION. 


The  masticating  organs  of  the  camel,  which  subsists  on  the 
coarsest  herbage,  show  a  much  stronger  resemblance  to  those 
of  carnivorous  animals  than  do  those  of  the  human  being  ;  and 
hence,  if  we  are  to  judge  the  natural  dietetic  character  of  man 
from  the  standpoint  of  comparative  anatomy  alone,  we  must 
place  him  at  a  farther  remove  from  flesh-eaters  than  is  the 
camel.  It  can  hardly  fail  to  be  noticed  by  the  attentive  reader 
that  the  irregular  arrangement  of  the  teeth  peculiarly  fit  the 
animal  for  munching  and  breaking  up  the  branches,  sprouts, 
stalks,  etc. ,  which  constitute  a  large  proportion  of  its  food. 

Fig.  ii. 


JAW  AND  TEETH  OF  THE  CAMEL. 


The  articulation  of  the  lower  jaw  also  admits  of  the  lateral, 
rotary,  and  grinding  motions,  as  with  all  grass-eating,  grain- 
eating,  and  fruit-eating  animals. 


Fig.  12. 


In  the  jaw  of  the  horse,  Fig.  12,  the  in- 
cisors, or  cutting-teeth,  are  placed  in  front, 
to  enable  it  conveniently  to  crop  the  grass 
and  other  herbage  ;  and  the  grinding-teeth, 
for  mashing  and  comminuting  the  food> 
occupy  the  back  part.  There  is  no  trace 
whatever  of  tearing,  or  carnivorous  teeth. 

In  the  orang-outang,  Fig.  13,  which  is 
a  purely  frugivorous  animal,  the  articula- 
tion of  the  jaws  admits  of  the  grinding 
motion.  In  some  of  the  monkey  tribes,  the  baboon  for 
example,  the  cuspids  do  resemble  the  corresponding  teeth  of 
the  carnivora  ;  they  are  not,  however,  used  for  flesh-eating,  but 


SKULL  OF  THE  HORSE. 


INSALIVATION. 


29 


seem  to  be  an  arrangement  which  serves  them  for  weapons  of 
offence  or  defence. 

The  distinctions  of  the  human  teeth  are  seen  in  the  illustra- 
tion, Fig.  14.  The  incisors  (I)  are  intended  for  biting  and 
cutting  the  fruits,  nuts,  grains,  or  whatever  may  be  his  proper 
food ;  the  cuspid  or  corner-tooth  (C),  sometimes  called  canine 


Fig.  13. 


JAWS  AND  TEETH  OF  AN  ORANG-OUTANG 


from  its  resemblance  to  the  corresponding  tooth  of  the  dog, 
-enables  him  to  grasp  more  firmly  and  retain  more  securely  the 
alimentary  substance  ;  and  the  bicuspids  (B)  and  molares  (G) 
-which  are  the  small  and  large  grinders,  are  fitted  to  mash  and 
comminute  all  solid  kinds  of  food. 

The  following  communication  to  the  Science  of  Health,  by 
Mrs.  Fannie  R.  Fendye  of  Baltimore,  Md.,  may  fittingly  con- 
clude this  branch  of  our  subject,  premising,  however,  that  it  is 
not  1 '  betel-eating "  but  better  mastication  and  fewer  unhygi- 


30 


DIGESTION. 


Fig.  14. 


HUMAN  JAW  AND  TEETH. 


cnic  habits  which  make  the  contrast  between  Oriental  and  Oc- 
cidental teeth  so  unfavorable  to  us — realizing  the  dream  ol 
Giles  Corey,  who  was  pressed  to  death  for  the  crime  of  witchcraft 
in  ' '  Salem  Town  "  some  two  hundred  years  ago  : 

"  I  saw  a  man  pull  all  his  teeth — 
It  took  him  but  a  minute  ; 
He  oped  his  mouth  and  put  them  back — 
I  thought  ye  deuce  was  in  it." 


THE  TEETH  AMONG  DIFFERENT  NATIONS. 

"  In  all  the  cities  of  south-eastern  Asia  I  found  not  a  single 
dentist,  with  the  solitary  exception  of  one  in  Calcutta.  And 
even  he,  I  think,  has  since  retired  for  want  of  employment, 
and  gone  home  in  disgust — resolved,  henceforth,  to  live  among 
people  sufficiently  1  civilized '  to  destroy  their  own  teeth  and 
wear  artificial  ones  instead.  This  paucity  of  supply  must  indi- 
cate a  want  of  demand  ;  as  it  is  unquestionably  true  that  the 
ranks  of  the  dental  profession  are  ever  increasing — the  colleges 
of  our  own  country  alone  sending  out  regularly  graduates 
enough,  it  is  said,  to  supply  the  world.  In  India  there  are 
merchants,  lawyers,  clergymen,  physicians,  druggists,  soldiers, 
sailors,  teachers,  and  mechanics,  both  native  and  foreign. 
Only  dentists  are  lacking,  and  the  reason  is  because  they  are 
not  needed. 

' '  Everybody  has  fine  teeth  in  the  East.  I  have  seen  both 
men  and  women,  at  ninety,  with  perfect  teeth,  and  seldom  ono 


INSALIVATION. 


31 


under  fifty  who  had  lost  a  single  incisor  or  cuspid,  and  perhaps 
not  even  a  molar. 

"  Two  European  gentlemen,  aged  respectively  twenty-six  and 
thirty,  were  one  day  conversing  with  a  young  Siamese  noble, 
who  remarked  that  he  could  never  guess  the  age  of  foreigners, 
as  they  looked  so  different  from  natives.  The  younger  of  the 
two  then  said,  'What  do  you  imagine  my  age  to  be?' 
'  About  nineteen  or  twenty,  I  suppose, '  was  the  reply. 
'But  really,  I  think  you  look  even  younger/  'Well,  but 
see  here, '  said  the  foreigner  ;  1 1  have  lost  a  tooth, '  pointing 
far  back  in  his  mouth  to  the  place  from  which  one  of  his  '  wis- 
dom-teeth '  had  recently  been  extracted.  '  Have  you, 
indeed?'  asked  the  noble,  manifesting  great  concern — 'then 
you  must  be  eighty  or  ninety.  I  did  not  think  you  were  so 
old.' 

"The late  kingofSiam,  who  died  at  the  age  of  sixty-five,  had 
a  set  of  teeth  that  our  proudest  belle  would  have  gloried  in — 
except  the  color,  for  he  always  had  them  painted  black — the 
Siamese,  in  common  with  most  oriental  nations,  deeming 
white  teeth  a  vulgarity.  Paint  for  the  teeth  is  in  the  East  as  in- 
dispensable an  article  of  the  toilet,  as  powder  and  rouge  for 
that  of  a  French  woman.  Even  young  ladies  with  pearly  teeth 
so  exquisitely  beautiful  that  it  would  seem  sacrilege  to  mar 
their  gleaming  whiteness,  will,  as  soon  as  they  become  of  age, 
— that  is,  ten  years  old,  after  which  they  are  considered  marriage- 
able— commence  staining  the  teeth,  first  red,  and  afterwards 
jet  black,  and  so  they  are  worn  through  life.  But  this  is  by  no 
means  to  avoid  the  trouble  of  keeping  the  teeth  in  neat  condi- 
tion ;  for,  as  a  general  rule,  orientals  take  far  more  care  of  the 
teeth  than  do  most  western  nations. 

"Toothache  is,  I  think,  utterly  unknown  in  the  East,  except 
among  white  foreigners,  as  I  do  not  remember  to  have  found 
a  single  case  among  the  natives.  Certainly  there  must  be  some 
cause  for  this  marked  exemption  from  diseases  of  the  teeth.  It 
may  be  due,  in  part,  to  the  constant  use  of  the  betel  or  artca-nut, 
which  all  classes  and  both  sexes,  in  nearly  every  part  of  India, 
chew  all  day  long.    They  combine  with  the  betel,  chunam, 


32 


DIGESTION. 


pepper-leaves,  and  fine-cut  tobacco — little  trays  containing  these 
various  ingredients  of  the  popular  quid,  standing  about  in 
every  apartment,  ready  to  be  offered  to  honored  or  welcome  guests, 
the  moment  they  are  seated.  Not  to  offer  it,  is  deemed  a  lack 
of  hospitality,  or  an  intimation  that  the  visitor  is  not  received 
as  an  equal  or  friend.  Eating  betel  is  in  Southern  and  Eastern 
Asia,  just  what  eating  salt  is  in  Western  Asiatic  countries — a 
token  and  bond  of  perpetual  friendship,  that  not  even  a  rogue 
or  a  murderer  would  violate.  Those  who  have  once  partaken 
together  of  the  '  betel  quid, '  are  thenceforth  sworn  friends,  till 
death  sunders  the  compact.  The  arica  is  highly  astringent,  like 
the  nut-gall ;  and  from  this  quality  may  tend,  in  some  mea- 
sure, to  the  preservation  of  the  teeth.  Another  cause  is, 
probably,  found  in  the  extremely  regular  habits  of  all  classes 
in  regard  to  meals,  with  which  nothing  is  allowed  to  interfere. 
When  dinner-time  comes,  an  oriental  dines >  whether  he  is  at 
leisure  or  not ;  and  he  would  do  so,  I  think,  if  a  beleaguering 
foe  were  thundering  at  his  gates.  But  between  meals  they  never 
eat.  Such  habits  in  regard  to  eating,  cannot  fail  to  be  pro- 
motive of  the  general  health,  and,  of  course,  the  teeth  share  the 
benefit.  A  still  more  potent  cause  is,  I  think,  the  fact  that 
orientals  never  take  either  food  or  drink,  very  hot  or  very  cold. 
Ice  is  unknown  in  most  parts  of  the  East,  and  none  but  for- 
eigners, or  those  who  have  learned  it  from  them,  make  any 
attempt  to  find  a  substitute  for  ice,  by  artificial  cooling  pro- 
cesses. Tea  and  fruit  juices  are  the  beverages  most  in  favor ; 
the  former  taken  without  cream  or  sugar,  and  only  moderately 
warm ;  while  the  latter  are  used  just  as  they  are  expressed  from 
the  fresh,  ripe  fruit.  How  absolutely  opposite  to  the  habits  of 
nearly  every  American,  at  home  or  abroad  !  It  is  said  by  those 
who  have  taken  pains  to  inform  themselves  on  the  subject,  that 
there  is  no  country  in  the  world,  civilized  or  savage,  where  bad 
teeth  are  so  generally  the  rule,  and  good  ones  so  rare  an  excep- 
tion, as  the  United  States.  And  there  is  probably  no  other 
nation  who  so  generally  swallow  tea  and  coffee  hot  enough  to 
scald  the  throat,  and  then  'cool  off'  by  an  immediate  draught 
of  iced-water.    An  Englishman  would  regard  such  a  habit  as 


THE  TEETH. 


33 


absolutely  suicidal,  and  he  is  amazed  that  sensible  Americans  so 
recklessly  jeopardize  health  and  life.  At  English  hotels i  people 
can,  of  course,  have  whatever  they  demand  and  pay  for,  as  at 
public  houses  elsewhere ;  but  in  private  families  in  England, 
even  the  wealthy,  the  use  of  ice  is  only  moderate  and  occasional 
— not  by  any  means  the  constant,  every-day,  excessive  affair  it 
is  with  us  ;  and  there  it  is  never  taken  immediately  after  hot  drinks, 
as  at  breakfast  and  supper  among  Americans.  Neither  do 
English  people  eat  irregularly,  and  at  all  hours  between  meals, 
as  do  many  of  our  countrymen — a  practice  by  which  the  diges- 
tive organs  must  become  impaired  and  the  general  health 
suffer,  even  if  the  teeth  did  not. 

"  Another  deleterious  practice,  common  in  our  large  cities 
especially,  is  the  excessive  use  of  ice-cream  and  soda-water. 
Nothing  is  more  common  on  summer  evenings,  than  for  young 
people  to  swallow,  at  their  boarding-houses,  a  cup  or  two  of 
coffee  boiling  hot,  and  as  rapidly  as  if  they  were  drinking  for  a 
wager,  and  then  to  rush  out  for  an  ice-cream  or  glass  of  soda, 
"to  cool  off  with" — the  "fruit  syrups"  of  the  soda  water  often 
containing  ' '  fusil  oil  "  and  other  poisons,  apart  from  the  delete- 
rious effects  on  the  teeth  of  these  extremes  of  heat  and  cold 
following  each  other  in  quick  succession.  A  distinguished 
dentist  told  me  recently,  that  it  was  difficult  to  conceive  of  any- 
thing wore  absolutely  destructive  to  the  teeth  than  the  simultaneous 
use  of  cold  and  hot  drinks.  And  he  added  that  he  had  known 
scores  of  Europeans,  who  came  to  the  United  States  with  teeth, 
that,  with  the  habits  of  living  to  which  they  had  been  accus- 
tomed at  home,  would  probably  have  lasted  to  extreme  old 
age — glad,  in  less  than  five  years  after  they  came  amongst  us, 
to  avail  themselves  of  the  services  of  a  dentist  to  manufacture  an 
artificial  'set/ 

' '  Surely  something  may  be  done,  to  avert  this  wide-spread 
curse  of  toothache  and  discolored,  uncomely  teeth,  or  the  only 
alternative  that  remains  of  wearing  those  not  '  to  the  manor 
born  so  that  Americans  of  future  generations,  at  least,  may 
cease  to  enjoy  the  enviable  distinction  of  belonging  to  a 
toothless  nation. " 


34 


DIGESTION. 


CHAPTER  IV. 


5 


DEGLUTITION. 


7      5.  The  Tubercle  behind  the  Incisor  Teeth. 


1 7  2.  The  Soft  Palate. 

3.  The  Velum  Pendulum  Palati. 

4.  The  Ridges  seen  on  the  Roof  of  the  Mouth. 


6.  The  Middle  Line  of  the  Hard  Palate. 

7.  Orifices  of  some  of  the  Mucous  Follicles. 

8.  The  Tonsil. 

9.  The  Pharynx. 


Fig.  15.— A  View  of  the  Roof  of  the  Mouth  and  of 
the  Soft  Palate.  ' 


1.  The  Roof  of  the  Mouth,  bounded  by  the  Superior 
Dental  Arch. 


After  the  food  has  been  properly  masticated,  it  is  to  be  swal- 
lowed. The  next  process,  therefore,  is  deglutition.  And  it  is 
worth  a  moment's  delay  to  consider  the  ample,  if  not  wonderful 
contrivances  for  effecting  the  passage  of  the  food  from  the 
mouth  to  the  stomach,  without  the  artificial  aid  of  drink. 

On  each  side  of  the  mouth,  at  the  commencement  of  the 
Pharynx  (back  part  of  the  mouth),  is  a  glandular  organ,  termed 
Tonsil,  whose  office  is  to  furnish  a  lubricating  fluid.  This  is 
shown  in  the  cut,  Fig.  15,  8.  In  addition  to  these  glands, 
the  whole  mucous  surface  exhales  a  moistening  and  lubricating 
fluid,  more  refined  than  any  oleaginous  matter  ever  produced 
by  artificial  means,  that  used  in  sewing  machines  not  excepted. 
This  secretion  is  formed  in  tubes,  called  Mucous  Follicles,  the 
orifices  of  some  of  which  are  shown  at  7.  Persons  who  use 
very  hot  drinks,  and  irritating  condiments,  or  strong  alkalies, 
\ sometimes  have  a  thickening  of  the  mucous  membrane  of  the 
oesophagus,  which  renders  deglutition  difficult. 


II 


CHYMIFICATION. 


35 


CHAPTER  V. 

CHYMIEICATIOBT. 

The  second  stage  of  digestion,  in  the  processes  of  the  trans- 
formation of  the  food  elements  into  living  structure,  is  termed 
chymification.  This  is  performed  in  the  stomach.  The  older 
physiologists  regarded  digestion  in  the  stomach  as  analogous  to 
fermentation  ;  modern  authors  are  very  discordant  in  their 
opinions  of  the  nature  of  the  process,  some  regarding  it  as 
mainly  mechanical,  and  others  as  purely  chemical.  The  sim- 
ple truth  is,  it  is  a  vital  process,  as  are  all  other  processes  per- 
taining to  living  organisms. 

In  the  stomach  the  food  is  mingled  with  a  solvent,  called  the 
gastric  juice,  whose  wonderful  properties  have  thus  far  eluded  all 
chemical  and  microscopical  investigations.  It  is  known  to  be 
slightly  acid,  and  to  have  a  power  of  transforming  organic  ele- 
ments unlike  that  of  any  other  known  substance.  It  is  said, 
also,  to  "digest"  inorganic,  and  even  metallic  substances, 
which  have  been  purposely  or  accidentally  swallowed  ;  but  this 
opinion  is  certainly  an  error,  for  oxidation,  or  decomposition, 
tvhich  is  all  that  can  happen  to  them  in  the  gastric  cavity,  is  a 
rery  different  process  from  digestion. 

A  general  view  of  the  abdominal  organs  is  represented  in  Fig. 
1 6.  The  adipose  matter  in  the  chest  has  been  removed,  as  has 
the  Greater  Omentum,  which  covers  the  viscera  in  front.  The 
liver  also  has  been  turned  back  to  exhibit  its  under  surface  and 
the  Lesser  Omentum, 

It  will  be  noticed  that  the  stomach  is  nearly  semicircular  in 
shape,  concave  above  and  toward  the  liver  on  the  right  side, 
convex  toward  the  spleen  on  the  left  side,  and  that  its  main 
bulk  is  on  the  left  of  the  median  line.  The  stomach,  heart, 
and  spleen  are  all  chiefly  on  the  left  side,  a  provision  which 
seems  necessary  to  counterbalance  the  largest  glandular  organ 
of  the  body,  the  liver,  which  is  situated  on  the  right  side.  A 
knowledge  of  this  arrangement  of  the  organs  enables  us  to  un- 
derstand many  of  the  complicated  and  obscure  pathological 


36 


DIGESTION. 


Fig.  16. 

i.  The  gread  Blood-vessels.  2.  The  Lungs  of  each  side.  3.  The  Heart.  4.  The 
Diaphragm.  5.  Under  surface  of  the  Liver.  6  The  Gall-Bladder.  7.  Union  of  the 
Cystic  and  Hepatic  Ducts  to  form  the  Ductus  Choledochus,  which  empties  the  bile  into 
the  Duodenum  immediately  below  the  pit  of  the  stomach.  8.  Anterior  Face  of  the 
Stomach.  9  The  Gastro- Hepatic,  or  Lesser  Omentum.  10.  Gastro-Colic,  or  Greater 
Omentum,  cut  off  to  show  the  small  intestines.  11.  Transverse  Colon,  pushed  a  little 
downwards.  12  Its  ascending  portion,  also  pushed  down.  13.  Small  Intestines.  14. 
The  Sigmoid  Flexure  of  the  Colon.    15.  Appendicula  Vermiformis. 

conditions  resulting  from  congestion  and  enlargement  of  the 
liver.  When  congested,  its  very  weight  causes  a  painful,  drag- 
ging sensation  in  the  vicinity  of  the  stomach,  and  when  very 
much  enlarged  it  causes  the  body  to  bend  to  one  side,  especially 
in  young  persons,  often  resulting  in  double  curvature  of  the 


CHYMIFICATION. 


37 


spine.  I  have  known  several  children  who  were  badly  incur- 
vated,  attended  in  some  instances  with  partial  or  complete 
paralysis  of  one  of  the  lower  extremities.  And  I  have  known 
such  patients  treated  for  months  with  tonics,  showering,  elec- 
tricity, "  movements,"  and  some  worse  things,  without  benefit, 
and  without  any  suspicion  on  the  part  of  the  attending  physicians 
of  the  real  nature  of  the  difficulty.  In  other  cases  its  pres- 
sure against  the  stomach  would  cause  much  distress  in  that 
organ,  especially  after  meals.  In  still  other  cases  its  upward 
pressure  against  the  diaphragm  would  cause  continual  diffi- 
culty of  breathing,  occasioning  short  breath,  coughing,  and 
palpitation,  whenever  the  patient  would  step  hurriedly,  or  walk 
up-stairs,  often  resulting  in  severe  asthmatic  paroxysms. 
These  patients  can  never  be  cured,  as  the  reader  will  readily 
understand,  until  the  diseased  condition  of  the  liver  is  pro- 
perly attended  to. 

The  relation  of  the  stomach  to  the  great  blood-vessels  below 
the  heart,  enables  us  to  explain  many  strange  and  often  frightful 
sensations  with  which  all  dyspeptics  are  more  or  less  familiar. 

The  illustration,  Fig.  i  7,  represents  the  stomach  and  oesopha- 
gus in  their  natural  position,  and  shows  the  proximity  of  the 
stomach  to  the  descending  aorta  and  other  large  blood  vessels  of 
the  abdominal  cavity.  The  thoracic  viscera,  nearly  all  of  the 
diaphragm,  and  the  intestines,  have  been  removed  ;  the  peri- 
toneum (lining  membrane  of  the  cavity  of  the  abdomen)  has 
been  detached  from  the  kidneys,  and  the  duodenum  is  left. 

One  of  the  most  distressing  symptoms  of  many  dyspeptics  is 
a  hard  beating  or  throbbing  behind  the  stomach.  It  is  gene- 
rally worse  soon  after  lying  down,  and  the  throbbing  is  some- 
times so  violent  as  to  jar  the  whole  body  and  shake  the  bed- 
stead. Many  persons  in  this  condition  have  apprehended 
"organic  disease  of  the  heart,"  and  not  unfrequently  their 
physicians,  unable  to  account  for  these  occasional  tumults  of 
the  central  organ  of  the  circulation  on  any  other  hypothesis, 
have  diagnosticated  4 'heart  disease." 

A  reference  to  the  illustration  will  make  the  matter  plain 
enough.    All  dyspeptics  have  one  of  four  conditions,  and 


33 


DIGESTION. 


Fig.  17.  ~ 
Stomach  and  Great  Blood-vessbls. 

1.  Upper  portion  of  the  (Esophagus. 

2.  Arch  of  the  Aorta. 

3.  Lower  portion  of  the  CEsophagus. 

4.  Vertebral  Column. 

5.  Vena  Cava  Ascendens. 

6.  Pancreas. 

7.  The  cut  edge  of  the  Diaphragm. 

8.  Great  Cul-de-Sac  of  the  Stomach. 

9.  Cardiac  orifice  of  the  Stomach. 

10.  Pyloric  orifice  of  the  Stomach. 

11.  Spleen. 

12.  The  Peritoneal  Coat  of  the  Stomach 
partially  turned  off. 

13.  Right  Kidney. 

14.  Lower  curvature  of  the  Duodenum. 

15.  Ascending  Vena  Cava. 

16.  Abdominal  Aorta. 

17.  A  section  of  the  lower  bowel  (Rectum). 

many  all  of  them.  1.  Consti- 
pation. 2.  Enlargement  of  the 
liver.  3.  A  contracted  and  rigid 
state  of  the  abdominal  mus- 
cles. 4.  Congestion  of  the  ad- 
jacent organs  —  lungs,  spleen, 
Sidneys  and  pancreas.  Either  condition  causes  obstruction  to 
the  free  passage  of  the  current  of  blood  down  the  descending 
aorta,  and  when  all  co-operate,  the  effect  is  extreme.  The  swol- 
len organs  and  unyielding  muscles  press  the  stomach  directly 
against  the  large  blood-vessel,  so  that  every  contraction  of  the 
1  left  ventricle  of  the  heart  propels  a  column  of  blood  through 
the  arteries  on  which  the  stomach  presses,  not  only  causing  the 
jarring  or  throbbing  sensation,  but  actually  lifting  the  lower 
side  of  the  stomach  to  some  extent.  The  effect  is  exactly 
analogous  to  that  of  moderate  blows  or  rappings  against  the 
under  side  of  the  stomach.  If  the  region  around  the  stomach 
is  contracted,  as  is  the  case  with  many  "  confirmed  dyspeptics/' 
or  "caved  in,"  as  is  the  case  with  all  women  who  have  laced 
tightly  in  early  life,  this  pounding  symptom  is  greatly  aggravated. 
In  such  cases  the  patient,  on  retiring  to  rest  and  assuming  the 


C  H  YMIFIC  ATION. 


39 


horizontal  position,  will  often  experience  noises  in  the  ears  like 
the  "sound  of  many  waters/'  or  the  rushing  of  a  cataract. 
This  symptom  is  also  always  worse  soon  after  taking  a  full  meal , 
and  if  such  a  person  take  a  "hearty  supper,"  and  retire 
immediately  to  bed,  his  sensations  will  be  more  forcible  than 
agreeable  ;  and  his  unquiet  slumbers  will  alternate  with  parox- 
ysms of  incubus,  preceded  by  frightful  spectres,  fantastic  situa- 
tions, impossible  adventures,  and  all  the  goblins  of  air,  earth, 
and  sea. 


Fig.  18.— Front  View  of  the  Stomach. 


i.  Anterior  Face  of  the  (Esophagus.  2.  The  Cul-de-Sac,  or  greater  Extremity. 
3.  The  lesser  or  Pyloric  Extremity.  4.  The  Duodenum.  5.  A  portion  of  the  Peritoneal 
Coat,  turned  back.  6.  A  portion  of  the  Longitudinal  Fibres  of  the  Muscular  Coat.  7. 
The  Circular  Fibres  of  the  Muscular  Coat.  8.  Oblique  Muscular  Fibres.  9.  Portion  of 
the  Muscular  Coat  of  the  Duodenum,  shown  by  removing  the  Peritoneal  Coat. 

The  process  of  chymification  means  simply  the  formation  of 
the  food  material  into  a  homogenous,  pulpy  mass.  For  this 
purpose  it  is  mixed  with  the  gastric  juice  and  compressed  and 
kneaded  by  the  muscles  which  constitute  the  middle  coat  of 
the  stomach.  The  fibres  of  this  muscular  coat  are  so  arranged 
as  to  do  their  work  admirably,  as  is  shown  in  the  illustration, 
Fig.  18,  which  represents  a  front  view  of  the  stomach,  distended 
with  air,  the  peritoneal  coat  being  turned  back. 

It  will  readily  be  seen  that  this  arrangement  of  longitudinal, 
circular  and  oblique  muscular  fibres  allows  the  stomach  to 


40 


DIGESTION. 


compress  and  knead  the  ingesta  in  all  possible  directions,  as 
the  varied  motions  of  the  tongue  enable  it  to  move  the  food  in 
the  mouth,  during  mastication,  in  every  direction. 

The  active  principle,  or  solvent,  of  the  gastric  juice,  is  evi- 
dently corpuscular,  as  is,  probably,  that  of  all  organic  secretions. 
A  something  analogous  to  this  has  been  obtained  from  the 
analysis  of  the  gastric  juice,  and  termed  pepine ;  but  pepine 
in  the  living  organism,  just  as  nature  produces  it,  and  pepine 
out  of  the  living  organism,  as  the  chemist  prepares  it,  are  very 
different  materials,  although  the  latter  does  produce  a  solvent 
effect  on  alimentary  substances.  But  the  idea  of  introducing 
pepine  into  the  materia  medica  as  a  substitute  for  the  gastric 
juice,  or  as  a  remedy  for  indigestion,  is  as  absurd  as  would  be 
the  notion  of  preparing  our  food  in  such  a  manner  as  not  to 
require  mastication.  Indeed,  this  latter  practice  is  very  general, 
for,  do  not  learned  physicians  tell  us,  and  eminent  physiologists 
explain  to  us,  that  bread,  for  example,  when  made  light  by 
fermentation,  can  be  more  readily  permeated  by  the  saliva  and 
gastric  juice  ?  Surely  they  forget,  when  treating  of  dietetics,  the 
nature  of  the  physiological  function  termed  mastication. 

The  pepine  which  is  employed  as  a  "digester"  in  medicine, 
is  usually  obtained  from  the  stomachs  of  pigs,  by  scraping  the 
mucous  membrane  with  a  blunt  instrument.  In  order  to  pro- 
duce it  in  large  quantities  the  animals  are  kept  without  food 
until  their  appetites  become  keen,  and  then  placed  where  they 
can  smell  the  food  without  getting  hold  of  it.  The  smell  of 
the  savory  viands  provokes  a  flow  of  gastric  juice,  or  of  some- 
thing analogous,  which  is  then  obtained  pure,  as  is  supposed, 
by  killing  the  animal.  But,  as  all  organic  secretions  are  modi- 
fied by  and  partake  of  the  dietetic  character  of  the  animal,  it 
seems  to  me  that  the  omnivorous  swine,  always  filthy  and 
scrofulous  in  its  domesticated  condition,  is  the  worst  possible 
source  from  which  to  obtain  pepine  for  the  human  stomach. 
The  peptic  corpuscles  of  a  scrofulous  pig  may  infect  the  human 
being  with  malignant  disease,  as  readily  as  the  vaccine  virus 
from  a  diseased  animal  produces  the  worst  forms  of  confluent 
small-pox. 


CHYMIFICATION. 


41 


The  corpuscles  of  the  gastric  juice  are  very  tenacious  of  life, 
as  are  all  similar  secretions.  In  rennet,  the  dried  stomach  of 
the  calf,  they  may  retain  their  organic  properties  for  years. 
One  of  the  peculiar  properties  of  gastric  juice,  is  that  of  coagu- 
lating milk.  Dr.  Fordyce  long  ago  ascertained  that  six  grains 
of  the  mucous  coat  of  the  stomach,  infused  in  water,  will  pro- 
duce a  liquid  that  will  coagulate  one  hundred  ounces  of  milk, 
or  6,857  times  its  bulk. 

It  has  been  ascertained  that  a  single  drop  of  gastric  juice  con- 
tains not  less  than  half  a  million  of  corpuscles,  and  that  the 
quantity  necessary  for  the  proper  digestion  of  a  single  meal 
may  be  reckoned  in  figures  at  not  less  than  130,000,000,000  ; 
a  number  that  need  not  surprise  us  when  we  recollect  that 
modern  scientists  have  estimated  the  constituent  molecules  of 
a  drop  of  water  at  several  billions. 

In  a  prize  essay  on  Cheese-making,  by  S.  R.  Arnold,  of 
Lansing,  Michigan,  published  in  1870,  the  author  claims  that, 
in  the  ordinary  process  of  cheese-making,  the  corpuscles,  or 
cells,  obtained  from  rennet,  are  not  destroyed  in  the  cheese, 
but  are  transferred  to  the  stomachs  of  those  who  eat  the  cheese, 
and  may  there  assist  digestion  ! 

But  this  is  pushing  nature  quite  out  of  the  universe.  If 
cheese,  or  anything  else  that  contains  gastric  corpuscles,  is 
necessary  or  useful  in  the  digestive  processes  of  the  human  sto- 
mach, how  are  those  human  beings  going  to  digest  their  vic- 
tuals who  have  not  cheese  or  something  similar  ?  And  how  are 
the  animals  that  never  use  any  pepine  except  the  home-made 
article,  to  get  along  ?  Old  cheese  is  well  known  to  be  one  of 
the  most  indigestible  articles  that  was  ever  swallowed  in  the 
name  of  food  ;  occasioning  constipation  of  the  bowels,  canker 
in  the  mouth,  dryness  of  the  mucous  surfaces,  and  deficiency 
in  both  the  gastric  and  salivary  secretions.  Says  the  old  dis- 
tich : 

"  Cheese  is  a  surly  elf, 
Digesting  all  things  but  itself." 

Perhaps  Mr.  Arnold  derived  his  philosophy  from  this  couplet 
of  the  muse.    But  it  is  not  truth,  whatever  may  be  said  of  the 


42 


DIGESTION. 


poetry.  It  is  an  unnatural  and  very  unwholesome  food  ;  in* 
deed,  it  is  not  food  at  all  in  the  proper  sense  of  the  word, 
though  containing  certain  alimentary  proximate  principles  in 
an  altered  and  degenerated  form.  B3cause  cheese  is  a  dry 
food,  that  is,  contains  little  water,  some  English  medical  writers, 
in  view  of  the  scarcity  and  high  prices  of  flesh-food,  consequent 
on  the  " rinderpest, "  "pleuro-pneumonia,"  and  "rot,"  among 
so  many  of  the  cattle  and  sheep  brought  to  the  London  mar- 
ket, have  recommended  cheese  as  a  substitute.  They  will  find 
a  much  better  article  of  diet  in  that  king  of  the  cereals,  wheat, 
provided  they  know  how  to  cook  it  hygienically,  or  in  any  one 
of  twenty  grains,  fruits,  and  roots  that  could  be  named. 

Another  peculiar  property  of  the  gastric 
secretion  has  been  called  antiseptic.  This 
term  is  not  strictly  correct,  for  antiseptic  ap- 
plies properly  only  to  dead  matter.  It  is  true, 
however,  that  partially  decayed  vegetables  and 
semi-putrescent  flesh,  lose  all  offensive  odor 
soon  after  coming  in  contact  with  the  gastric 
juice.  But  this  effect  results  from  the  trans- 
forming power  of  the  solvent,  by  which  the 
molecular  atoms  are  re-arranged  and  the  fetid 
gases  decomposed  and  dissipated.  All  that 
an  antiseptic  can  do  is  to  prevent  decay  by 
rendering  the  organic  elements  fixed  and  un~ 
changeable,  as  with  salt,  vinegar,  alcohol, 
arsenic,  etc.  This  is  why  all  salted  aliments 
are  more  indigestible  and  less  nutritious  than 
those  which  are  fresh. 

In  Fig.  20,  the  entrance  to  the  secreting 
follicles  are  shown,  in  the  cells  upon  the 
surface  of  the  mucous  membrane  of  tta 
stomach. 

The  mucous  membrane  is  so  completely 
studded  with  glands  for  the  secretion  of  the  gastric  juice  that 
its  surface  has  a  velvety  or  napped  appearance,  as  represented 
in  Fig.  19,  which  is  a  section  of  the  coals  of  the  stomach  near 


FIG.  19. 

Gastric  Glands. 


fig.  20. 
Secreting  Tubes. 


CHYLIFICATION. 


43 


the  pylorus,  showing  the  gastric  glands  magnified  twenty  dia- 
meters. 

The  immediate  consequences  of  a  deficient  supply  of  gastric 
juice — a  condition  that  exists  with  all  dyspeptics — are,  acidity, 
flatulence,  eructations,  water-brash,  heart-burn,  etc. 

After  the  food  has  been  duly  prepared  in  the  stomach  in 
the  manner  we  have  seen,  it  is  passed  through  the  pylorus 
(lower  orifice  of  the  stomach)  into  the  duodenum,  the  first 
portion  of  the  small  intestines.  The  pyloric  portion  of  the 
stomach  and  the  upper  portion  of  the  duodenum  are  liable 
to  become  ulcerated,  indurated,  tuberculated,  and  even  can- 
cerous in  persons  who  have  much  abused  their  digestive  or- 
gans with  strong  condiments,  indigestible  aliments,  alcoholic 
liquors,  or  other  poisons. 


CHAPTER  VI. 
CHYLIFICATI02ST. 

In  the  duodenum  the  food,  now  chyme,  is  mingled  with  the 
secretion  from  the  mucous  membrane  of  the  intestine  itself,  the 
bile,  and  the  pancreatic  juice.  Physiologists  do  not  yet  agree 
as  to  the  precise  offices  performed  in  the  organic  economy  by 
the  liver  or  pancreas.  The  bile  is  certainly,  in  part,  and  prob- 
ably wholly,  an  excrementitious  fluid,  or  excretion,  although 
being  of  an  alkaline  nature,  it  may  incidentally  mingle  with 
the  fatty  matters  of  the  food,  and  by  converting  them  into  a 
saponaceous  mass,  assist  in  their  passage  or  absorption.  All 
physicians  are  familiar  with  the  various  phases  of  disease  which 
result  from  a  deficient  excretory  action  of  the  liver.  Jaundice, 
rashes,  humors,  erysipelatous  affections,  dimness  of  vision, 
impaired  hearing,  and  a  multitude  of  cutaneous  eruptions  are 
attributable  to  "biliousness/' 

The  following  extract  from  the  author's  work,  "The  Hy- 
dropathic Encyclopcedia,"  may  be  pertinent  in  this  place  : 

"The  liver  forms  the  bile  from  the  venous  blood.  The  ob' 
ject  of  the  biliary  excretion  evidently  is  to  eliminate  certain  inv 


44 


DIGESTION. 


purities  from  the  body  in  the  form  of  compounds  of  carbon, 
hydrogen  and  nitrogen,  and  also '  to  deterge  the  blood  of  a 
portion  of  any  excess  of  alkali  that  may  be  absorbed  by  the  ve- 
nous extremities. 

* '  Liebig  has  fabricated  a"  singularly  inconsistent  hypothesis, 
which  has  satisfied  himself  and  all  others  who  are  satisfied  to 
echo  his  arguments  without  taking  the  trouble  to  examine 
them,  that  the  bile  is  a  nutritive  product,  and  that,  conse- 
quently, whatever  will  tend  to  the  formation  of  bile,  or  any  of 
the  proximate  elements  usually  found  in  bile,  is  a  useful  and 
nutritive  substance.  Liebig  reasons  in  this  wise  :  The  bile  is 
composed  of  several  certain  proximate  elements.  One  of  these 
is  called  taurine.  This  taurine  is  the  only  compound  or  prox- 
imate element  found  in  the  bile  which  contains  nitrogen.  Now 
theine  and  caffeine,  the  active  principles  of  tea  and  coffee,  are 
found,  on  chemical  analysis,  also  to  contain  a  very  small  quan- 
tity of  nitrogen  ;  ergo,  tea  and  coffee,  though  injurious  excit- 
ants to  the  nerves,  may  be  useful  to  the  liver  by  furnishing 
the  nitrogenous  element  of  the  taurine  of  the  bile.  Such  rea- 
soning is  extremely  absurd,  and  the  error  is  a  most  palpable 
one.  It  consists  in  mistaking  a  waste  material  for  an  aliment ; 
a  depurating  process  for  a  nutritive  one.  As  well  might  one 
mistake  putrid  flesh  for  wholesome  food,  because  it  contains 
carburetted  hydrogen,  which  is  also  found  in  the  foeces,  or  ex- 
crementitious  matters  of  the  bowels." 

The  pancreatic  juice,  mingling  with  the  oily  matters  of  the 
food,  or  with  the  food  (and  it  should  be  stated  here  that  oily 
matters  are  never  digested  nor  changed  in  the  stomach),  redu- 
ces them  to  the  condition  of  an  emulsion,  which  means, 
dividing  the  oily  particles  so  minutely  that  they  lose  their 
apparent  individuality.  In  this  emulsified  condition  the  fat  is 
capable  of  being  absorbed  and  carried  into  the  general  circu- 
lation, and,  finally,  expelled  through  the  various  emunctories, 
or  deposited  in  the  cells  of  the  areolar  tissue. 

The  spleen,  when  enlarged  and  indurated,  is  what  is  known 
in  popular  parlance  as  ' '  ague  cake. "  It  is  common  in  malarious 
districts  after  the  intermittent  fever  has  been  "  broken  up"  by 


INTESTINAL  DIGESTION. 


45 


large  doses  of  quinine  or  arsenic.  When  dyspepsia  is  compli- 
cated with  this  condition,  the  patient  is  always  despondent  and 
melancholy,  unless  the  organic  or  vital  temperament  exists, 
with  a  very  large  development  of  the  phrenological  organ  of 
hopefulness. 

The  relation  of  the  pancreas  to  the  spleen  on  the  left  side, 
and  the  duodenum  on  the  right,  is  shown  in  Fig.  21.  The 
cut  represents  the  organs  as  viewed  anteriorily,  with  their 
blood-vessels  injected. 


Fig.  21. — Pancreas,  Spleen,  and  Duodenum. 


The  spleen.  2.  Its  Diaphragmatic  Extremity.  3.  Its  Inferior  Portion.  4.  The 
Assure  for  its  Vessels.  5.  The  Pancreas.  6.  Its  Head,  or  the  Lesser  Pancreas.  7. 
duodenum.  8.  Coronary  Arteries  of  the  Stomach.  9.  The  Hepatic  Artery.  10.  The 
Splenic  Artery.    11.  The  Splenic  Vein. 


CHAPTER  VII. 

INTESTINAL  DIGESTION". 

From  the  commencement  of  the  small  intestines  to  the  ter- 
mination of  the  large  ones,  the  mucous  lining  of  the  canal 
secretes  a  fluid  which  not  only  smooths  the  passage  of  matters 
along  its  surface,  but  aids  in  the  elaboration  of  the  nutrient 
elements.  In  different  portions  of  the  alimentary  tract  there 
are  special  glands,  follicles,  or  other  secreting  structures,  aiding 
in  the  complex  process  of  converting  "  pabulum  "  into  living 
structures.  The  small  intestines  are  divided  by  anatomists  into 
the  duodenum,  jejunum,  and  ileum,  and  the  large  intestines  into 
the  cecum  colon  and  rectum,    A  glance  at  some  of  the  more 


46 


DIGESTION. 


prominent  of  these  special  appendages  to  the  digestive  apparatus 
will  not  only  show  how  ' '  fearfully  and  wonderfully "  we  are 
made,  but  may  induce  us  to  have  a  little  more  compassion  on 
our  own  bowels,  if  we  cannot  have  ' '  bowels  of  compassion  " 

for  others  ;  for  it  is  in  the 
long  and  tortuous  tract  of 
the  intestinal  canal  that 
the  most  aggravated  mise- 
ries of  a  dyspeptic  life  are 
experienced.  Choleras, 
colics,  diarrhoeas,  worms, 
hemorrhoids,  various  con- 
cretions, and,  worst  of  all, 
constipation,  have  their 
seat  in  the  intestinal  tube, 
in  addition  to  inflamma- 
tory affections  and  struc- 
tural derangements,  which 
are  common  to  all  parts 
of  the  system. 

In  Fig.  22,  is  seen  a 
section  of  the  ileum,  in- 
verted, so  as  to  show  the 
appearance  and  arrange- 
Fig.  22.— Section  of  the  Ilium.  ment  of  the  villi  C!\  an  ex- 
tended surface,  as  well  as  the  follicles  of  Lieberkuhn.  The 
follicles  are  represented  by  the  great  number  of  black  points 
between  the  villi,  or  proiections,  and  can  only  be  recognized 
by  a  close  inspection. 

A  section  of  the  small  intestine  containing  some  of  Peyer's 
glands,  as  shown  under  the  microscope,  is  represented  in  Fig. 
23.  They  secrete  a  milky  fluid  with  numerous  corpuscles  of 
various  sizes,  but  not  so  large  as  those  of  the  blood.  The 
meshes  seen  in  the  folds  are  the  ordinary  tripe-like  folds  of  the 
mucous  coat. 

Several  late  pathologists  have  advanced  the  theory  that  an 
inflammation  of  Payer's  glands  in  '.he  jejunum  and  ileum,  is  the 


INTESTINAL  DIGESTION. 


47 


essential  cause  of  typhoid,  or  enteric  fever,  while  an  inflamma- 
tion of  Brunner's  glands,  in  the  duodenum,  is  the  essential 
cause  of  typhus  or  putrid  fever.  But  these  theorists  have  mis- 
taken effect  for  cause.  In 
some  instances  these  glands 
were  found  inflamed  or  dis- 
organized after  death.  In 
other  cases  no  such  appear- 
ances were  discoverable. 
If  inflammation  of  these 
glands  was  the  cause  of 
these  fevers,  post-mortem 
examinations  should  have 
confirmed  it  in  all  cases. 

The  entire  number  of 
follicles  in  the  whole  ali- 
mentary canal  has  been 
reckoned  by  Dr.  Horner 
( ' '  Special  Anatomy  and 
Histology, ")  at  "  forty-six 
million  nine  hundred  thou- 
sand and  upwards. "  They 
constitute  the  minute  ana- 
tomy of  the  mucous  coat, 
and  their  most  prominent 
phases  are  represented  in 
the  four  following  illustra- 
tions : 

Fig.  24,  is  a  view  of  the 
follicles  of  the  colon,  mag- 
nified one  hundred  and  fif- 
teen times.     Their  aggre-         Fig.  24.-Follicles  of  the  Colon. 

gate  number  is  estimated  at  nearly  ten  millions. 

Fig.  25,  is  a  view  of  the  folds  and  follicles  of  the  stomach, 
highly  magnified.  About  two  hundred  and  twenty-five  are  found 
on  every  square  of  an  eighth  of  an  inch,  which  would  give  a 
little  more  than  a  million  and  a  quarter  for  the  entire  stomach. 


43 


DIGESTION. 


In  Fig.  26,  are  seen  the  follicles  and  villi  of  the  jejunum 
highly  magnified.    As  the  villi  are  erected  by  the  injection, 

they  run  into  each  other 
and  press  one  upon  an- 
other like  the  convolu- 
tions of  the  cerebrum. 

The  follicles  and  also 
the  villi  of  the  ileum, 
highly  magnified,  are 
represented  in  Fig.  27. 
These  villi  are  curved, 
with  their  edges  bent 
in,  on  concave.  There 
is,  however,  in  the  whole 
alimentary  canal,  al- 
most every  conceivable 
form  and  shape. 

It  is  in  the  large 
intestines,  where  fecal 
matters  are  liable  to 
accumulate,  that  the 
most  distressing  effects 
of  indigestion  are  man- 
ifested. Admirable  as 
are  their  structural  ar- 
rangements and  irregu- 
larly curviform  direc- 
tion for  the  performance 

Fig.  26.— Follicles  of  the  Jejunum.  of  their  functions  Under 

normal  conditions,  these  very  circumstances  render  them  liable 
to  become  the  seat  of  terrible  sufferings  when  obstructed  or 
diseased.  This  fact  may  be  inferred  from  a  glance  at  the 
illustration,  Fig.  28,  which  is  a  view  of  the  position  and  curva- 
tures of  the  large  intestines. 

The  large  intestines  differ  from  the  small  in  being  saccu- 
lated, an  arrangement  which  favors  the  retention  of  the  nu- 
trient material  which  has  not  yet  been  taken  up  by  the 


INTESTINAL  DIGESTION. 


49 


Fig. 


27. — Follicles  of  the  Ileum. 

ried 


extremities  of  the  veins  and  the  lacteals,  until  it  can  be  com- 
pletely absorbed,  and  also  facilitates  the  excretion  of  fecal 

matters  from  the  blood. 
But  if  constipation  ex- 
ist, these  sacculations 
become  loaded  with 
hardened  fceces,  and 
sometimes  with  other 
concretions,  rendering 
the  patient  as  miserabk 
as  can  well  be  ima- 
gined. 

It  will    be  noticeo 
that  the  contents  of  the 
large  intestines  are  ear- 
in  a  circuitous  route,  and 
in  one  place  directly  upward 
for  ten  or  twelve  inches  ;  thence 
across  the  abdominal  cavity  to 
the  right  side,  thence  down- 
ward on  the  left  side  to  a  posi* 
tion  below  the  ileo-coecal  junc- 
tion ;  thence  through  the  sig 
moid  flexure  (a  curvature  re 
sembling  the  letter  S),  and, 

1.  The  end  of  the  Ileum. 

2.  Appendicula  Vermiformis. 

3.  The  Ccecum,  or  Caput  Coli. 

4.  The  Transverse  Colon. 

5.  The  Descending  Colon. 

6.  The  Sigmoid  Flexure. 

7.  Commencement  of  Rectum. 

8.  The  Rectum. 

9.  The  Anus.— The  Levator-Ani  Muscle 
Fig.  28. — The  Large  Intestines.  is  shown  on  each  side. 

finally,  downward  again  in  a  straight  line  to  the  outlet. 

The  careless  observer  might  see,  in  this  extraordinary  con*- 
trivance,  nothing  but  a  useless  complication  that  renders  the 
whole  organism  ever  liable  to  manifold  infirmities  and  prema- 
ture destruction.    But  a  similar  mistake  has  been  made  with 


t 

50  DIGESTION. 

regard  to  the  convolutions  of  the  brain.  There  is  neither  sim- 
plicity nor  symmetry  on  the  encephalic  surface,  and  its  irre- 
gular elevations  and  depressions  seem,  to  the  non-philosophical 
mind,  but  a  promiscuous  and  useless  massing  together  of  brain 
substance.  But  the  physiologist,  and  especially  the  phreno- 
logist, sees  the  matter  with  very  different  eyes.  He  perceives 
the  use,  and  then  recognizes  the  beauty  of  the  whole  arrange- 
ment. He  has  learned  that  all  of  this  unevenness  of  surface 
unfolds  and  spreads  out,  so  to  speak,  the  mental  organs,  and 
correspondingly  augments  their  power. 

The  last  of  the  small  intestines  (ileum)  opens  into  a  large 
sac  or  pouch,  which  is  the  portion  of  the  large  intestine  termed 
coecum.  This  is  very  large  in  some  of  the  herbivorous  animals. 
In  the  horse  it  is  larger  than  the  stomach.  The  careful  student 
may  inquire,  for  what  purpose  is  the  little  tortuous  worm-like 
appendage  depending  from  the  lower  part  of  the  ccecum  ?  Well, 
it  has  no  physiological  use  whatever,  and  yet,  paradoxical  as  it 
may  seem,  "  nothing  is  made  in  vain."  Like  the  little  tri- 
jointed  bone  at  the  lower  extremity  of  the  vertebral  column,  it 
seems  to  point  a  moral.  It  is  the  relic  of  a  lower  organization, 
and  is  the  strongest  argument,  perhaps,  that  can  be  adduced 
in  favor  of  the  doctrine  of  "Evolution."  In  some  of  the 
lower  animals,  which  subsist  on  coarse  food  and  herbage,  the 
beaver,  for  example,  the  appendicula  vermiformis  constitutes 
another  pouch  or  stomach,  or  a  prolonged  ccecum.  As  the 
food  becomes  more  frugivorous  and  concentrated  in  the  ascend- 
ing scale,  the  appendage  is  not  needed,  and  perishes  by  non- 
use.  If  the  human  race  exists  long  enough,  and  continues  to 
develope  in  its  cerebro-spinal  tissue,  the  unseemly  excrescence 
will  entirely  disappear.  But  I  do  not  wish  to  be  understood 
as  interpreting  * '  Darwinism "  so  as  to  make  man  the 
' '  descendant "  of  the  lower  organizations.  My  opinion  is  that, 
in  the  order  of  progressive  development  he  has  ascended  above 
the  whole  animal  kingdom. 

A  view  of  the  whole  range  of  the  alimentary  canal  is  presented 
in  Fig.  29.    A  portion  of  the  oesophagus  has  been  removed  on 


INTESTINAL  DIGESTION. 


51 


The  arrows  indicate 


account  of  want  of  space  in  the  figure, 
the  course  traversed  by  the  ingesta. 

Fig.  29. 
Alimentary  Canal  in  situ. 
1.  The  Upper  Lip,  turned  off  at 
the  mouth.  2.  Its  Frcenum.  3. 
Lower  Lip,  turned  down.  4.  Its 
Froenum.  5,  5.  Inside  of  the  cheeks, 
covered  by  the  lining  membrane  of 
the  mouth.  6,  Points  to  the  opening 
of  Steno's  Duct.  7.  Roof  of  the 
mouth.  8.  Lateral  Half  Arches.  9 
Points  to  the  Tonsil.  10.  Velum 
Pendulum  Palati.  11.  Surface  of  the 
Tongue.  12.  Pappillae  near  its  point. 
13.  A  portion  of  the  Trachea.  14. 
CEsophagus.  15.  Its  Internal  Sur- 
face. 16.  Inside  of  the  Stomach. 
17.  Its  Greater  Extremity  or  great 
Cul-de-Sac.  18.  Its  Lesser  Extrem- 
ity or  smaller  Cul-de-Sac.  19  Its 
Lesser  curvature.  20.  Its  greater 
curvature.  21.  Cardiac  Orifice. 
22.  Pyloric  Orifice.  23.  Upper  por- 
tion of  Duodenum.  24,25.  Remain- 
der of  the  Duodenum.  26.  Its  Val- 
vulae  conniventes.  27.  Gall  Blad- 
der. 28.  Cystic  Duct.  29.  Divi- 
sion of  Hepatic  Ducts  in  the  Liver. 
30.  Hepatic  Duct.  31.  Ductus 
Communis  Choledochus.  32.  Its 
opening  into  the  Duodenum.  33. 
Pancreatic  Duct.  34.  Its  opening 
to  the  Duodenum.  35.  Upper  part39 
of  the  jejunum.  36.  Ileum.  37. 
Some  of  the  Valvulae  Conniventes. 

38.  Lower  extremity  of  the  Ileum. 

39.  Ileo  Colic  Valve.  40,  41.  Cce- 
cum.  42.  Appendicular  Vermifor- 
mis.  43,  44.  Ascending  Colom  45 
Transverse  Colon.  46,  47.  Descend- 
ing Colon.  48.  Sigmoid  Flexure  of 
the  Colon.  49.  Upper  portion  of  the 
Rectum.  50.  Its  lower  extremity. 
51.  Portion  of  the  Levator  Ani  Muscle.   52.  Anus. 

With  the  anatomical  data  before  us,  it  is  not  difficult  to 
understand  why,  in  cases  of  prolonged  constipation,  or  in  tor- 
pid and  feeble  states  of  the  alimentary  canal  and  abdominal 
muscles,  the  ccecal  pouch  should  be  the  portion  of  the  canal 


52 


DIGESTION. 


most  liable  to  obstructions  and  accumulations.  Many  persons 
of  good  constitutions,  not  conscious  of  any  very  bad  habits, 
who  live  "as  other  folks  do,"  and  attend  to  their  daily  busi- 
ness, suffer  continually  of  fcecal  collections  in  the  ccecum,  and, 
generally,  to  some  extent  in  the  colon  also,  especially  in  that 
portion  of  it  denominated  the  sigmoid  flexure,  without  the 
least  suspicion  of  the  real  cause  of  their  difficulties.  And 
physicians  of  extensive  practice  and  long  experience  not  unfre- 
quently  dose  such  patients  for  years  with  aperients,  cordials, 
stimulants,  tonics,  alteratives,  nervines,  and  opiates,  and  some- 
times with  mercurials  in  addition,  with  no  thought  of  the  nature 
of  the  troublesome  symptoms.  I  have  known  several  cases  in 
which  the  lower  extremities  were  so  feeble  and  the  back  so 
weak,  from  no  other  cause  than  the  one  we  are  considering, 
that  the  patients  could  not  walk  without  a  cane  in  each  hand. 

The  ordinary  symptoms  are,  a  sense  of  weight  or  heaviness 
in  one  or  both  iliac  regions,  with  occasional  dull  pains,  alter- 
nating more  or  less  frequently  with  aching  or  griping  sensations. 
Sometimes  the  sensation  in  the  part  will  be  of  a  dragging  or 
bearing-down  character,  in  extreme  cases  amounting  to  a  most 
intolerable  tormina  and  tenesmus  as  in  dysentery.  All  of  these 
symptoms  may  be  mild  or  severe  according  to  the  amount  of 
excrementitious  material  present  and  the  efforts  made  to  dis- 
lodge it.  Diarrhoea  may  also  be  present  without  removing  the 
constipation,  for  the  fcecal  matters  are  often  so  hardened  and 
impacted  that  fluid  dejections  pass  by  them  without  solving  or 
moving  them. 

Literary  and  sedentary  persons  are  much  more  liable  to 
obstructions  of  the  ccecum  and  colon  than  are  laboring  persons. 
Clergymen,  lawyers  and  legislators,  who  devote  much  time  to 
writing  or  studying,  and  do  not  give  proper  attention  to  diet 
and  exercise,  are  often  extreme  sufferers.  Were  it  proper  and 
useful  to  do  so,  I  could  give  the  names  of  distinguished  bishops, 
divines,  statesmen,  lawyers,  and  even  physicians,  who  have  been 
dragged  down  from  positions  of  honor  and  wealth,  to  moral 
degradation  and  poverty,  because  of  this  condition  of  their  bow- 
els, and  the  medical  treatment 


INTESTINAL  DIGESTION. 


53 


I  say  medical  treatment  advisedly.  The  condition  itself 
might  have  occasioned  disease  and  even  death.  But  it  would 
not  alone  occasion  dishonor.  Opiates  were  given  to  relieve 
pain,  and  stimulants  to  '  '  support  vitality. "  Their  effects  were 
only  temporary,  and  as  the  cause  was  not  removed  they  were 
frequently  repeated.  Soon  morphine  and  brandy  became 
necessities ;  and  eventually  drunkenness  became  a  habit,  fol- 
lowed in  some  instances  by  debauchery  and  other  vices.  Some 
of  the  readers  of  these  lines  may  remember  the  sad  story  of  two 
distinguished  prelates,  men  of  good  name  and  fame  and  unim- 
peachable piety,  occupying  the  exalted  positions  of  Bishops  of 
the  two  greatest  States  of  our  Union — New  York  and  Pennsyl- 
vania. They  were  brothers.  Both  were  degraded  from  their 
high  and  holy  office  for  intoxication  and  lecherous  conduct. 
The  unfortunate  men  were  more  sinned  against  than  sinning. 
It  was  shown  on  their  trial  that  the  medicine  which  had  worked 
their  ruin  had  been  prescribed  by  their  physicians. 

But,  to  say  nothing  of  the  various  entozoa  which  are  frequently 
found  in  different  parts  of  the  alimentary  canal,  all  of  which 
are  scavengers,  and  could  not  exist  were  it  not  for  the  morbid 
secretions  and  improper  ingesta,  there  is  another  group  of  ex- 
ceedingly distressing  affections  whose  seat  is  the  rectum.  I  mean 
hemorrhoids,  or  piles.  Chronic  inflammation  of  the  mucous 
surface  is  among  the  effects  of  prolonged  constipation,  and  this 
may  extend  from  the  mucous  membrane  of  the  coecum  and 
colon  to  that  of  the  rectum,  or  foecal  accumulations  may  occur 
in  the  rectum.  The  result  is,  the  numerous  veins  in  the  lower 
y  part  of  this  portion  of  the  intestinal  tube,  very  near  its  outlet, 
become  distended  into  tumors,  rupture  and  bleed,  or  the 
mucous  membrane  itself  becomes  disorganized,  and  portions 
of  it  are  hardened  with  excrescences  and  tumors  of  various 
forms,  sizes,  and  degrees  of  consistence.  In  these  cases  defe- 
cation is  always  painful,  and  the  pain  is  sometimes  excruciating. 
When  these  tumors  are  large  or  numerous,  or  the  whole 
mucous  membrane  greatly  relaxed,  the  tender  and  perhaps 
bleeding  bowel  will  prolapse  after  each  defecation,  in  many 
instances  only  to  be  replaced  with  difficulty  and  suffering.  In 


54 


DIGESTION. 


extreme  cases  these  tumors  are  removed  by  surgery— ligation  01 
caustic 


Fig.  30. — Muscles  of  the  Trunk,  in  Front. 
In  Fig.  30  are  seen  the  muscles  of  the  trunk  anteriorily.  The  superficial  layer  Is  seen 
on  the  left  side,  and  the  deeper  on  the  right.  1.  Pectoralis  major.  2.  Deltoid.  3.  Ante-^ 
rior  border  of  the  latissimus  dorsi.  4.  Serrations  of  the  serratus  magnus.  5.  Subclavius 
of  the  right  side.  6.  Pectoralis  minor.  7.  Coracho-brachialis.  8.  Upper  part  of  the 
biceps,  showing  its  two  heads.  9.  Coracoid  process  of  the  scapula.  10.  Serratus  magnus 
of  the  right  side.  11.  External  intercostal.  12.  External  oblique.  13,  Its  aponeurosis  ; 
the  median  line  to  the  right  of  this  number  is  the  linea  alba  ;  the  flexuous  line  to  the  left 
is  the  linea  semilunaris  ;  the  transverse  lines  above  and  below  the  number  are  the  lineae 
transversae.  14.  Poupart's  ligament.  15.  External  abdominal  ring ;  the  margin  above 
is  called  the  superior  or  internal  pillar ;  the  margin  below  the  inferior  or  external 
p'llar  ;  the  curved  intercolumnar  fibres  are  seen  proceeding  upward  from  Poupart's  liga- 
ment to  strengthen  the  ring.  The  numbers  14  and  15  are  situated  upon  the  fascia  lata  01 
the  thigh  ;  the  opening  to  the  right  of  15  is  called  saphenous.  16.  Rectus  of  the  right 
side.  27.  Pyramidalis.  18.  Internal  oblique.  19.  The  common  tendon  of  the  internal 
oblique  and  transversalis  descending  behind  Poupart's  ligament  to  the  pectineal  line. 
20.  The  arch  formed  between  the  lower  curved  border  of  the  internal  oblique  and  Poiy 
part's  ligament,  beneath  which  the  spermatic  cord  passes,  and  hernia  occurs. 


INTESTINAL  DIGESTION. 


55 


But  the  student  who  would  master  the  complex  physiology 
of  digestion,  should  not  overlook  one  important  auxiliary  which 
is  scarcely  alluded  to  in  medical  books,  and  not  mentioned  at 
all,  so  far  as  I  know,  by  the  standard  authors  on  Theory  and 
Practice,  in  connection  with  the  therapeutics  of  indigestion. 
I  mean  the  abdominal  muscles.  There  is  a  good  reason  why 
the  abdominal  viscera,  and  especially  the  alimentary  canal  should 
not  be  enclosed  within  bony  walls,  as  is  the  case  with  the  brain 
and  the  organs  of  the  thorax.  The  walls  of  the  abdomen  are 
formed  of  muscular  and  tendinous  bands,  which  are  thin,  flexi- 
ble, and  exceedingly  strong.  This  structure  provides  for  a 
great  degree  of  mobility  in  the  va- 
rious movements  of  the  body,  and 
aids  powerfully  in  the  peristaltic 
action  of  the  bowels.  In  the  act 
of  defecation  these  muscles,  co- 
operating with  the  action  of  the 
muscular  coat  of  the  intestinal 
canal,  compress  the  whole  abdo- 
men firmly  yet  steadily,  so  that 
the  contents  of  the  bowels  are 
moved  along  and  expelled  easily 
and  without  pain.  But  when 
these  muscles  are  inactive,  from 
rigidity  or  relaxation,  the  whole 
effect  is  thrown  upon  the  delicate 
fibres  of  the  muscular  coat  of  the 
intestines,  resulting  in  imperfect 
or  incomplete  defecation,  and, 
eventually,  torpor  and  exhaustion 
of  the  peristaltic  action. 

Fig.  31. — Muscles  of  the  Trunk,  laterally. 
Fig.  31  is  a  side  view  of  the  muscles  of  the  trunk.  1.  Costal  region  of  the  latissimus 
dorsi.  2.  Serratus  magnus.  3.  Upper  part  of  external  oblique.  4.  Two  external  inter- 
costals.  5.  Two  internal  intercostals.  6.  Transversalis.  7.  Its  posterior  aponeurosis. 
8.  Its  anterior.  9.  Lower  part  of  the  left  rectus.  10.  Right  rectus.  11.  The  arched 
opening  where  the  spermatic  cord  passes  and  hernia  takes  place.  12.  The  gluteus  maxi- 
mus,  and  medius,  and  tensor  vaginae  femoris  muscles  invested  by  fascia  lata, 


56 


DIGESTION. 


Many  ' '  wonderful  cures  "  have  been  effected,  of  dyspeptics 
who  had  been  dosed  and  drugged  for  years  unavailingly,  by 
simply  exercising  the  abdominal  muscles,  by  methods  which  will 
be  explained  hereafter. 


CHAPTER  VIII. 
ABSORPTION  OF  THE  NUTRIENT  ELEMENTS. 

The  nutritive  elements  o.  the  food  are  taken  from  the  ali- 
mentary canal  by  the  extremities  of  the  veins,  and  by  the  lac- 
teal vessels,  which  originate  in  the  small  intestines.  The 
process  of  absorption  commences  in  the  stomach  and  extends 
nearly  or  quite  the  entire  length  of  the  intestines.  The  venous 
absorbents  convey  their  contents  directly  to  the  mass  of  blood, 
while  the  lacteal  transport  the  matters  which  they  take  up 
through  the  mesenteric  glands  to  the  receptaculum  chili,  whence 
they  are  emptied  into  the  blood  near  the  heart. 

In  the  stomach  the  more  watery  portions  of  the  aliment,  and 
such  elements  as  require  little  elaboration,  are  taken  up  by  the 
extremities  of  the  veins.  When  milk  is  taken  the  watery  part 
is  absorbed  and  the  solid  portions  reduced  to  a  coagulum,  or 
curd,  before  gastric  digestion  can  take  place.  The  lacteal 
absorbents  convey  the  more  dense  and  oleagenous  elements, 
termed  chyle,  which  is  usually  of  a  milky  white  color;  but 
this  depends  much  on  the  quality  of  the  ingesta,  being  nearly 
transparent  in  those  who  use  little  or  no  fatty  matters  in  or  with 
their  food. 

A  provision  for  the  farther  elaboration  of  the  chyle  is  found 
in  the  mesenteric  glands,  which  are  convolutions  of  the  absorb- 
ent vessels  numerously  distributed  along  their  course. 

Fig.  32  is  a  view  of  the  beautiful  arrangement  of  these  chyle- 
carriers.  They  are  represented  as  injected.  The  arteries  of 
the  jejunum  and  mesentery  are  also  injected. 


ABSORPTION  OF  THE  NUTRIENT  ELEMENTS. 


57 


Fig.  32. — Lymphatics  of  Jejunum  and  Mesentery. 


1.  Section  of  the  Jejunum. 

2.  Section  of  the  Mesentery. 

3.  Branch  of  the  superior 
Mesenteric  artery.  4. 
Branch  of  the  superior  Me- 
senteric Vein.  5.  Mesente- 
ric Glands  receiving  the 
Lymphatics  of  the  intestines. 

The  structure  and 
arrangement  of  the 
mesenteric  glands 
are  better  shown  in 
Fig.  33,  which  is  a 
view  of  the  lympha- 
tics as  they  appeared  after  death  of  abdominal  dropsy. 

1.  Thoracic  Duct.  2.  Sec- 
tion of  the  Aorta.  3.  Glands 
around  the  Aorta  which  receive 
the  Lymphatics  from  the  intes- 
tine and  give  off  vessels  to  the 
Thoracic  Duct.  4.  Superficial 
Lymphatics  on  the  intestine. 
5,  5.  More  Lymphatic  glands 
receiving  vessels  from  the  in- 
testine. 6,  7.  Lymphatics  from 
the  intestine  and  mesentery. 

All  of  the  muscles1 
of  the  abdomen  are 
auxiliary  to  respiration 
as  well  as  to  digestion. 
Indeed  they  constitute 
the  chief  forces  in  the 
act  of  expiration  ;  and 
without  they  are  main- 
tained in  a  vigorous  condition  by  appropriate  exercise,  neither 
breathing  nor  digestion  can  be  well  performed.  In  the  act  of 
vomiting  the  spasmodic  contraction  of  these  muscles  is  the  main 
force  that  ejects  the  contents  of  the  stomach,  and  in  the  various 
forms  of  cholera  and  diarrhoea,  it  is  mainly  the  same  force,  ab- 
normally exerted,  that  causes  the  evacuations.  Hence  it  becomes 
as  necessary  to  regulate  the  action  of  these  muscles  in  fluxes 
knd  profluvia,  as  to  invigorate  them  in  cases  of  dyspepsia. 


Fig-  33- — Mesenteric  Glands. 


53 


DIGESTION. 


The  course  and  termination  of  the  Thoracic  Duct,  and  its 
relations,  are  represented  in  Fig.  34. 

Fig.  34.— Thoracic  Duct. 
1.  Arch  of  the  Aorta.  2.  Thoracic  Aorta.  3 
Abdominal  Aorta.  4.  Arteria  Innominata.  5,  Left 
(  Carotid  Artery.  6.  Left  Sub-Clavian  Vein.  7. 
Superior  Vena  Cava.  8.  The  two  Veins  termed 
Venae  Innominatae.  9.  Internal  Jugular  and  Sub- 
Clavian  Vein  at  each  side.  10.  Vena  Azygos.  11. 
Termination  of  the  Vena  Hemi- Azygos  in  the  Vena 
Azygos.  12.  Receptaculum  Chyli ;  several  Lympha- 
tic Trunks  are  seen  opening  into  it.  13.  The  Thora- 
cic Duct,  dividing  opposite  the  Middle  Dorsal  Verte- 
bra in  two  branches,  which  soon  re-unite  ;  the  course 
of  the  Duct  behind  the  Arch  of  Aort2  and  Left  Sub- 
Clavian  Artery  is  shown  by  a  dotted  line.  14.  The 
Duct  making  its  turn  at  the  Root  of  the  Neck  and 
receiving  several  Lymphatic  Trunks  previous  to  ter- 
minating in  the  Posterior  Angle  of  the  Junction  of  the 
Internal  Jugular  and  Sub-Clavian  Veins.  15  Ter- 
mination of  the  Trunk  of  the  Lymphatics  of  the 
Upper  Extremity. 

What  precise  changes  the  chyle  un- 
dergoes in  passing  through  the  mesen- 
teric glands  is  not  known,  but  as  all 
glands  are  secreting,  excreting,  or 
elaborating  organs,  it  is  certain  that 
the  influence  they  exert  on  the  nutri- 
tive fluid  is  important;  hence  it  is 
essential  to  perfect  digestion  that  these 
minute  and  complicated  structures  are 
not  deranged  nor  impaired.  And  just 
here  is  another  consideration  of  no  small  importance.  It  is 
said  by  some  medical  authors,  that  when  mercurial  and  other 
mineral  drugs  come  in  contact  with  the  mesenteric  glands,  they 
4 'take  on"  inflammation.  The  phrase  is  absurd,  but  the 
meaning  intended  to  be  conveyed  is,  the  medicine  or  poison 
(as  it  is  administered  with  therapeutic  or  homicidal  intent), 
occasions  inflammation  of  the  glands  ;  and  the  rationale  is,  the 
vital  structures,  recognizing  the  presence  of  an  enemy  within 
the  vital  domain,  resist  or  oppose  it  by  determining  the  blood 
to  the  part.    The  inflammatory  process,  however,  although  it 


ABSORPTION  OF  THE  NUTRIENT  ELEMENTS.  59 


retards,  does  not  prevent  the  passage  of  the  drug  ;  for,  as  it  is 
necessary  for  the  chylous  fluid  to  be  passed  along,  the  mineral 
particles  which,  in  the  form  of  oxides,  chlorides,  or  salts,  are 
exceedingly  minute,  pass  along  with  it.  The  glands  may  be 
permanently  diseased  in  this  matter,  and  this  method  of  getting 
drug-medicines  into  the  blood  is  always  more  or  less  damaging 
to  these  delicate  structures,  and  is  the  origin  of  most  of  the 
tumors  which  are  seated  in  the  mesentery,  and  which  are  be- 
yond the  reach  of  medication  or  surgery.  In  some  cases  hun- 
dreds, and  in  other  cases  thousands  of  these  glands  are  involved 
in  the  formation  of  an  indurated  irregular  tumor  and  sometimes 
occupying  a  large  portion  of  the  abdominal  cavity.  If  invalids 
must  have  their  blood  and  tissues  pervaded  with  the  agencies 
of  the  drug  shop,  the  safer  way  is  to  administer  them  hypoder- 
mically.  By  injecting  them  into  the  skin  they  will  pass  directly 
into  the  blood,  and  thus  save  the  wear  and  tear  of  the  digestive 
organs.  When  repeated  doses  of  potent  drugs  are  sent  into  the 
circulation  through  the  long  and  devious  route  of  the  digestive 
apparatus,  the  effect  is  not  unlike  that  of  the  march  of  an 
invading  army  through  an  enemy's  country.  If  the  aggressive 
forces  put  on  their  best  possible  behavior,  they  are  enemies  still, 
and  more  or  less  desolation  will  mark  their  track.  And  in  view 
of  the  fact  that  we  have,  in  the  United  States,  thirty  thousand 
drug  shops,  and  seventy-five  thousand  physicians,  furnishing 
the  supplies  and  prescribing  the  doses,  it  may  be  a  fair  question 
for  a  debating  lyceum,  whether  there  is  more  dyspepsia  pro- 
duced by  drug  medication  than  by  all  other  causes  combined  ? 


CHAPTER  IX. 
AERATION  OF  THE  EOOD  ELEMENTS. 

But  the  processes  of  digestion  are  not  completed  until  the 
nutrient  material  reaches  the  lungs.  In  the  respiratory  organs, 
it  receives  its  finishing  elaboration,  which  fits  it  for  assimilation. 
And  here  is  another  consideration  for  dyspeptics  which  is  set 


6o 


DIGESTION. 


dom  sufficiently  regarded,  if,  indeed,  it  is  ever  thought  of. 

No  food  can  be  assimilated  unless  properly  aerated.  Each  particle 
of  food  must  come  in  contact  with  a  particle  of  atmospheric  air, 
or  it  can  never  be  used — else  it  is  worse  than  useless.  For  this 
purpose  it  is  diffused  through  the  lungs  with  the  blood  which 
is  there  decarbonized.  All  of  the  venous  and  lacteal  absorbents, 
as  we  have  seen,  convey  the  nutrient  matters  which  they  take 
up  from  the  stomach  and  small  intestines  to  the  right  side  of 
the  heart,  as  do  all  the  venous  extremities  and  lymphatics  which 
originate  in  the  large  intestines.  From  the  right  side  of  the 
heart  it  is  conveyed,  with  the  venous  blood  from  all  parts  of  the 
system,  to  the  lungs. 

The  function  of  aeration  is  not  fully  understood.  It  is  well 
known  that  in  respiration  the  blood  is  purified  of  its  effete  car- 
bon, and  that  oxygen  is  received  into  the  system.  But  it  is 
not  known  that  oxygen  performs  any  other  office  than  to  com- 
bine with  and  reduce  to  ashes,  and  thus  favor  the  expulsion  of 
the  disintegrated  or  dead  matters.  Oxygen  is  usually  termed 
"  vital  air,"  but  I  suppose  the  vitalizing  element  is  something 
very  different. 

So  far  as  we  can  trace  the  effects  of  oxygen,  they  are  purely 
destructive.  Of  course  it  is  just  as  important  to  get  rid  of  the 
offal,  to  remove  the  effete  matters  from  the  system,  as  it  is  to 
supply  wholesome  food.  And  for  this  purpose  a  full  supply 
of  oxygen  is  a  vital  condition.  But  this  does  not  make  it  in  any 
sense  "  vital  air,"  any  more  than  nitrogen  is  vital  air,  for  a  due 
admixture  of  this  gas  with  the  oxygen  is  just  as  essential  to 
health  as  is  the  presence  of  the  oxygen. 

Pure  oxygen  is  as  non-respirable  as  is  nitrogen,  carbonic 
acid  gas,  or  hydrogen  ;  although  a  larger  proportion  of  it  in  the 
atmosphere  than  nature  provides  may  be  borne  for  a  time  with- 
out serious  inconvenience.  Those  empyrics,  however,  who 
run  the  business  of  treating  diseases  with  "Compound  Oxygen,,, 
"Super-Oxygenated  Air,"  "Vitogen,"  and  other  humbugs, 
must  either  be  arrant  ignoramuses,  or  have  great  faith  in  human 
credulity.  These  enterprising  gentlemen  might  as  well  under- 
take to  invent  better  kinds  of  food,  or  a  superior  quality  of 


AERATION  OF  THE  FOOD  ELEMENTS. 


6l 


water  than  nature  has  been  enabled  to  accomplish,  by  chang- 
ing the  proportions  of  their  constituent  elements,  as  to  imagine 
they  can  improve  the  atmosphere  nature  has  provided  for  us 
to  breathe. 

In  my  opinion  the  vitalizing  principle  which  may  pervade 
any  organic  structure,  and  which  is  especially  received  in  respi- 
ration, is  an  element  inconceivably  more  refined  than  oxygen 
or  its  nascent  condition,  ozone,  and  more  etherealized  than 
even  the  all-pervading  electricity  or  magnetism,  and  which  fills 
all  that  part  of  the  unmeasurable  universe  which  is  called  space. 
But,  for  all  practical  purposes  it  is  enough  to  know  that  perfect 
respiration  is  essential  to  perfect  nutrition,  and  that  every  influ- 
ence which  diminishes  the  breathing  capacity,  correspondingly 
impairs  digestion  and  conduces  to  dyspepsia. 

All  impurities  of  the  atmosphere  tend  to  enfeeble  the  respira- 
tory, and  indirectly,  the  nutritive  functions,  as  do  all  habits  of 
dress  or  positions  of  body  which  impede  the  action  of  the  respi- 
ration. And  here  I  must  allude  to  two  prevalent  causes  of  dys- 
pepsia, consumption,  and  general  physical  deterioration,  which 
are  not  only  destroying  the  young  men  and  young  women  of 
our  land  at  a  fearful  rate,  but  are  alarmingly  on  the  increase 
all  over  the  country. 

I  cannot  do  better  justice  to  this  branch  of  our  subject 
than  by  quoting  a  few  paragraphs  from  one  of  my  works  on 
■  Tobacco-Using,"  recently  published  at  the  office  of  the  Health 
Reformer,  at  Battle  Creek,  Michigan  : 

' 1  THE  BREATH  OF  LIFE. 

"There  is  one  view  of  the  physical  evils  of  tobacco-using 
which  has  never  been  presented  distinctly  by  writers  on  this 
subject.  I  mean  the  effect  of  the  habit  of  respiration.  Tobacco- 
using  directly  and  fearfully  lessens  the  breathing  capacity.  This  is 
one  reason  why  tobacco-users  require  more  sleep  than  others, 
other  circumstances  being  equal.*    Now,  the  available  life- 

*  The  less  the  nervous  energies  are  exhausted  by  nervines,  stimulants,  or  narcotics  of 
any  kind,  or,  indeed,  by  pernicious  habits  of  any  sort,  the  less  will  be  the  amount  of  sleep 
required  for  recuperation. 


62 


DIGESTION. 


force  of  every  living  being  is  precisely  in  the  ratio  of  the  devel- 
opment of  the  respiratory  organs.  Tobacco-using,  so  long  as 
it  is  continued,  constantly  diminishes  the  breathing  apparatus. 
This  is  easily  explained.  Any  one,  on  going,  on  a  hot  sum- 
mer's day,  from  the  stifling  stenches  of  an  uncleaned  city,  to  the 
purer  breezes  of  the  open  country,  may  have  a  realizing  sense 
of  the  principle  involved.  His  lungs  will  expand  spontane- 
ously. They  seem  to  open  full  and  deep  to  take  in  as  much 
vital  air  as  possible.  It  is  a  luxury  to  breathe.  But  in  the 
dirty  city,  the  accumulated  impurities  of  the  atmosphere  are 
resisted  by  the  pulmonary  structures.  The  glottis  partially 
closes  to  keep  them  out,  and  all  of  the  respiratory  muscles 
contract  spasmodically  to  prevent  their  entrance.  Breathing 
is,  therefore,  imperfect.  And  when  the  atmosphere  is  very 
impure,  breathing  is  not  only  imperfect  but  painful ;  and  in 
extreme  cases  it  is  entirely  suspended. 

' '  Now,  nothing  is  more  offensive  to  the  vital  instincts  of  the 
respiratory  organs  than  the  odor  and  fumes  of  tobacco.  Talk 
about  stenches,  miasms,  contagions,  infections,  from  gutters, 
cess-pools,  markets,  stables,  distilleries,  tenement  houses,  offal 
gatherings,  &c.  !  All  of  them  combined  (let  me  gently  hint  to 
the  Board  of  Health)  do  not  equal  tobacco  in  intrinsic  repul- 
siveness,  nor  in  their  injurious  effects  on  the  lungs. 

' 1  Let  any  one,  uncontaminated  by  its  use,  enter  a  close  room 
where  several  persons  are  smoking,  or  a  crowd  in  the  street 
where  fashionable  young  men  most  do  congregate,  and,  in  a 
moment,  he  will  find  himself  breathing  short  and  laboriously. 
He  will  experience  a  sense  of  suffocation,  and  perhaps  feel  an 
inclination  to  sneeze,  retch,  or  vomit.  His  lungs  expand  with  , 
difficulty.  They  do  not  kindly  receive  the  particles  of  the 
deadly  narcotic.  Inhalation  is  feeble  and  imperfect,  while  ex- 
piration is  more  forcible  and  complete.  And  thus  the  lungs 
are  exercised  in  just  the  manner  gradually  and  surely  to  contract 
the  diameter  of  the  chest  and  permanently  diminish  the  respi- 
ratory capacity.  And  as  our  whole  population  is  more  or  less 
exposed  to  an  atmosphere  strongly  impregnated  with  tobacco 
effluvia,  the  vital  function  of  respiration  cannot  fail  to  suffer  a 


AERATION  OF  THE  FOOD  ELEMENTS. 


63 


continual  deterioration.  And  all  that  is  necessary  to  insure  the 
ruin  of  the  human  race  at  no  distant  day  is  the  increase  of  the 
habit  of  tobacco-using  as  rapidly  as  it  has  increased  for  three 
centuries  past,  or  as  rapidly  as  it  is  increasing  at  the  present 
time.  Frightful  examples  of  this  possible  result  may  be  seen 
in  droves  in  all  of  our  cities  and  large  villages. 

4  4  Look  at  the  swarms  of  young  men — young  in  years,  but  old 
in  vital  conditions — who  commenced  this  horrid  practice  in 
early  life ;  and  thousands  do  commence  it  even  before  the  age 
of  puberty.  The  close  observer  will  not  fail  to  notice  in  a  ma- 
jority of  them,  something  unshapely  and  unhuman — 4he  sharp 
features,  angular  faces,  projecting  shoulders,  lank  limbs,  nar- 
row chests,  gaunt  abdomens,  sallow,  bilious  skin,  and  old-man- 
ish  appearance  generally.  To  the  eye  of  the  intelligent  phy- 
siologist these  young  men — mere  boys  in  the  order  of  nature — 
are  prematurely  old,  already  in  a  decline.  I  have  seen  thou- 
sands of  tobacco-using  young  men  (of  twenty  to  twenty-five 
years  of  age,  according  to  the  almanac)  who  were  physiologi- 
cally and  for  all  practical  purposes,  older  than  thousands  of 
their  fathers  and  grandfathers  were  at  fifty  to  sixty  years  of  age. 
A  large  proportion  of  tobacco-using  young  men  are  dwarfed  in 
body  and  mind  irrecoverably  ;  and  should  they  unfortunately 
become  husbands  and  fathers,  their  wives  may  well  be  pitied, 
while  their  offspring  will  in  most  cases  be  constitutionally  frail 
and  precociously  dissolute,  and  many  of  them  imbecile,  if  not 
idiotic. 

"  Many  of  these  young  men  have  the  characteristics  of  disso- 
luteness and  sensuality  stamped  indelibly  on  the  physiognomy 
as  well  as  the  physiology.  And  with  many  of  them — indeed 
all,  to  a  greater  or  less  extent — their  secretions  are  all  morbid, 
their  excretions  defective  ;  their  whole  mass  of  blood  foul,  their 
breath  fetid,  their  sweat  nauseous,  and  their  whole  persons 
offensive. 

"  young  men  the  chief  smokers. 

"As  we  trace  the  history  of  tobacco-using  from  one  genera- 
tion to  another,  it  is  all  downward — from  bad  to  worse.  The 


64 


DIGESTION. 


fathers  of  many  of  the  tobacco-using  young  men  of  the  present 
day  did  not  commence  the  habit  until  they  had  acquired  a  fair 
vital  development.  But  they  transmitted  morbid  propensities 
to  their  children,  who  commenced  much  earlier  in  life.  Hence 
there  is  frequently  a  striking  contrast  between  the  compara- 
tively stalwart  tobacco-using  father,  and  the  puny,  fragile, 
stunted,  and  inferior  tobacco-using  son.  It  is  not  difficult  to 
imagine  what  their  sons  must  be. 

"It  is  worthy  of  remark  that,  as  a  general  rule,  persons  who 
become  addicted  to  tobacco-using  (and  the  same  is  true  of 
liquor-drinking)  in  early  life,  indulge  more  excessively  than 
do  those  who  commence  in  middle  or  mature  life.  Being 
excitable,  the  consequent  depression  is  greater ;  hence  the 
seeming  necessity  for  more  frequent  repetitions. 

"  A  few  days  since,  I  noticed  an  illustration  of  this  statement, 
which  will,  I  think,  be  found  of  extensive  application.  I  was 
travelling  from  Philadelphia  to  New  York.  The  car  in  which  I 
was  seated  contained  just  forty  persons.  Eight  of  them  were 
young  men  ;  twenty-two  would  pass  for  middle-aged,  and  ten 
were  old  persons — six  men  and  four  women.  All  of  the  young 
men  (and  this  was  not  the  " smoking  car,  forward")  smoked 
cigars  or  huge  meerschaums  more  than  half  of  the  whole  dis- 
tance ;  only  two  of  the  middle-aged  men  smoked  at  all,  and 
then  cigars  only  on  one  occasion  for  a  few  minutes  ;  while  but 
one  of  the  old  gentlemen  befouled  himself  and  the  rest  of  us  by 
smoking  at  all.  I  have  made  similar  observations  on  all  the 
leading  railroads  of  the  United  States,  and  I  am  of  the  opinion 
that  if  any  person,  travelling  in  any  part  of  the  country  by  rail, 
steamer,  ferry,  or  stage,  will  study  this  subject  closely,  he  will 
find  that  the  principal  smoking  is  done  by  the  young  men. 
Tens  of  thousands  of  young  men  may  be  seen  every  Sunday 
standing  around  the  corner  groceries,  and  the  thousands  of 
tobacco  shops  (which  find  Sunday  their  principal  business  day 
of  the  week),  smoking  their  lives  away,  and  bestenching  the 
atmosphere  which  others  are  obliged  to  breathe.  And  in  every 
public  gathering  outside  of  a  church,  it  may  be  readily  noticed 


TOBACCO-USING. 


65 


that  the  principal  smoking  is  performed  by  the  young  men  and 
boys. 

i '  Tobacco-using,  in  young  persons,  has  the  same  effect  in 
diminishing  the  breathing  capacity  that  tight-lacing  (which  is 
alarmingly  on  the  increase  again)  has.  Some  years  ago,  when 
the  practice  of  tight-lacing,  which  has  ruined  many  thousands 
of  young  ladies,  induced  the  friends  of  humanity  and  of  the 
future  generations,  to  make  special  efforts  to  arrest  the  evil, 
many  young  men  adopted  the  maxim,  'natural  waists  or  nc* 
wives/  It  is  a  pity  the  maxim  was  not  more  generally  lived  up 
to.  But  these  young  ladies  might  very  well  reciprocate  the 
compliment  while  they  accepted  the  philosophy  in  adopting  the 
adage,  '  natural  mouths  or  no  husbands. '  Examples  are,  in- 
deed, sadly  frequent  on  the  thoroughfares  of  our  great  cities,  of 
young  ladies  who  have  destroyed  more  than  one-half  of  their 
breathing  capacity  by  this  disgraceful  habit  of  tight-lacing. 
They  cannot  possibly  live  to  be  old  ;  they  can  never  become 
mothers  of  healthy  children  ;  and  while  they  do  live  they  must 
be  infirm  and  miserable  in  themselves,  and  a  source  of  anxiety 
and  sorrow  to  their  friends.  They  are  invalids  for  life.  Their 
wan,  expressionless  faces,  harsh,  pinched,  contracted  features, 
with  livid,  bilious  discolorations  of  the  skin,  proclaim  in  lan- 
guage that  the  physiologist  cannot  mistake,  deficient  respiration 
and  imperfect  depuration.  And  the  counterpart  of  these 
appearances  and  indications  may  be  seen  in  numerous  young 
men  who  promenade  the  streets  behind  lighted  cigars. 

4 'But  although  the  physiological  result  is  the  same  in  the 
cases  of  tobacco-using  young  men  and  tight-lacing  young 
women,  there  is  a  considerable  difference  anatomically.  In 
the  case  of  the  young  ladies  the  obstruction  to  respiration  is 
external  and  mechanical,  hence  there  is  greater  deformity,  or 
'  caving  in/  of  the  vital  organs,  while,  with  the  young  men, 
there  is  less  malformation  or  deformity  of  the  chest. 

"Let  a  tobacco-using  young  man  and  a  tight-lacing  young 
woman  marry,  and  what  must  be  the  character  of  the  off- 
spring ?  We  can  see  melancholy  specimens  enough  on  every 
hand. 


66 


DIGESTION. 


1 '  Now  the  only  method  which  has  ever  proved  effectual  for 
preventing  or  curing  consumption  is,  to  keep  the  lungs  ex- 
panded as  much  as  possible.  And  for  this  purpose,  breathing 
tubes,  spirometers,  blow-guns,  lifting  machines,  and  other 
gymnastic  contrivances,  have  been  found  useful. 

A  LEARNED  DISCUSSION  ON  TOBACCO. 

f<I  cannot  better  illustrate  the  delusion  that  may  exist  in 
high  places,  even  among  the  learned,  on  the  subject  of  tobacco- 
using,  than  by  the  relation  of  the  following  incident :  In  1862, 
I  attended  the  annual  meeting  of  the  British  Scientific  Associa- 
tion, in  Cambridge,  England.  In  the  section  on  Physiology, 
a  paper  was  read  on  the  evil  effects  of  tobacco-using.  The 
author  stated  very  clearly  the  various  morbid  conditions  and 
diseases  which  are  well  known  to  result  from  the  habit,  and 
quoted  a  respectable  array  of  medical  authorities  who  declared 
it  to  be  extremely  pernicious.  The  discussion  that  followed 
the  reading  of  the  paper  was  amusing,  if  not  instructive.  Every 
one  who  spoke  on  the  subject  (and  they  were  all  medical  gen- 
tlemen), condemned,  not  the  tobacco,  but  the  author  of  the 
essay!  ' He  was  not  a  competent  judge/  'His  opinions 
were  of  no  authority/  '  He  was  no  physiologist,' etc.  All 
who  spoke,  advocated  the  use  of  tobacco — moderately,  of 
course.  One  gentleman  said  that,  '  next  to  alcohol,  tobacco 
was  the  best-abused  article  in  existence. '  Another  stated  that 
he  had  used  the  '  weed '  for  twenty-three  years  without  being 
harmed  by  it.  A  third  regarded  it  'favorable  to  mentality,'  a 
fourth  considered  its  employment  in  moderation  '  decidedly 
hygienic. '  A  fifth  said,  '  I  always  find  my  ideas  to  flow  more 
consecutively  after  a  few  whiffs  from  a  good  cigar ;'  and  a  sixth 
justified  its  use  by  reference  to  the  Turks,  '  who  used  tobacco 
freely,  yet  were  a  strong  and  courageous  race. '  No  one  replied 
a  word  to  the  facts,  or  pretended  to  meet  the  arguments  pre- 
sented in  the  paper ;  but  all  who  spoke,  contented  themselves 
with  the  utterances  of  opinions  in  praise  of  tobacco,  and  de- 
nunciations of  the  author.  Surely,  if  an  association  of  scienti- 
fic men  whose  members  claim  to  be  as  learned  a  body  as  exists 


TIGHT-LACING. 


67 


on  the  earth,  can  gravely  utter  such  arrant  fallacies,  we  need 
not  wonder  at  the  wide-spread  ignorance  of  the  non-professional 
people  on  this  subject. 

The  importance  of  the  subject  of  tight-lacing,  and  abnormal 
positions  when  habitually  assumed,  as  affecting  respiration  and 
digestion,  cannot,  perhaps,  be  better  stated  and  illustrated  than 
in  the  following  chapter  on  ' '  Popular  Physiology,"  a  serial 
work  now  being  published  in  the  ' '  Science  of  Health. "  The 
illustrations  are  from  a  work  by  the  author,  entitled,  "The 
Illustrated  Family  Gymnasium." 

BODILY  POSITIONS. 

' 1 A  single  glance  at  the  situation  of  the  various  organs  of 
the  body,  with  respect  to  each  other  and  to  the  bony  skeleton, 
shows  the  importance  of  maintaining,  under  all  circumstances, 
the  normal  position.  Erectitude  is  one  of  the  most  obvious 
laws  of  the  vital  machinery,  yet  almost  every  one  is  crooked. 
'Blessed  are  the  upright/  physically  as  well  as  morally. 

"Each  structure  and  organ  is  provided  with  all  the  room 
necessary  for  its  functional  purposes,  but  no  more.  Nature  is 
a  rigid  economist.  She  never  wastes.  She  provides  the  ma- 
chinery of  life,  and  the  conditions  for  its  normal  operation. 
Obey  the  law  and  live,  disobey  and  die — these  are  her  irrepeal- 
able  mandates.  The  vital  organs  have  definite  relations  to 
everything  in  the  universe.  Observe  and  conform  to  these 
relations  and  be  well ;  disregard  them  and  suffer.  Such  is  the 
stern  teaching  of  Nature's  volume,  but  it  is  also  benevolent. 
If  laws  can  be  disregarded  with  impunity,  they  are  practically 
annulled,  and  exist  in  vain.  Nature  commits  no  error  in  the 
enactment  of  law,  and  provides  no  remedies  for  their  infraction. 
Suffering  is  inevitable  so  long  as  we  act  in  disobedience  to  the 
laws  inherent  in  the  vital  organism.  Unless  this  were  so  we 
could  never  learn  to  obey  the  laws.  Experience  may  be  a  dear 
school.  The  penalties  for  transgression  may  be  terrible.  But 
neither  is  too  costly  or  severe  until  it  teaches  us  the  greatest 
practical  truth  that  the  human  mind  is  capable  of  comprehend- 


68 


DIGESTION. 


ing — that  all  good  is  in  the  line  of  obedience  to  organic  law, 
and  all  evil  in  opposition  thereto. 

"  'Cease  to  do  evil  and  learn  to  do  well '  in  all  things,  is  the 
divine  philosophy,  and  applicable  to  every  department  of 
human  life.  In  few  things  are  human  beings  more  prone  to 
do  evil  and  more  regardless  of  all  health  considerations  than  in 
respect  to  bodily  positions. 

'Just  as  the  twig  is  bent  the  tree's  inclined. ' 

"  A  great  majority  of  children  in  our  primary  schools  become 
more  or  less  abnormally  inclined  in  manhood,  because  they  are 
bent  out  of  shape  in  childhood  by  unhygienic  seats  and 
benches. 

"In  the  cut  ^Fig.  35 ;  are  seen  the  situation  and  relations 
of  the  principal  internal  organs  of  the  body. 

"  The  important  lesson  deducible  from  the  illustration  before 
us  is,  that  in  all  of  our  exercises,  active  or  passive,  we  should 
maintain  the  normal  positions  of  the  organs.  In  lying,  sitting, 
standing,  walking,  running,  working  or  playing,  use  the  joints, 
and  never  bend  or  compress  any  other  organ,  part  or  struc- 
ture. 

"It  is  evident  that,  if  the  body  is  habitually  bent  so  as  to 
approximate  the  heart,  A,  and  stomach,  D,  or  if  the  chest  is 
restricted  by  lacing,  so  as  to  lessen  the  diameter  of  the  chest  in 
the  region  of  the  diaphragm,  d,  every  organ  of  the  thoracic  and 
abdominal  cavity  is  more  or  less  compressed,  and  most  of 
them  actually  displaced. 

"The  horrid  effects  of  tight-lacing  (quite  as  ruinous  to  young 
ladies  as  tobacco-using  is  to  young  men),  or  of  lacing  at  all, 
and  of  binding  the  clothing  around  the  hips,  instead  of  sus- 
pending it  from  the  shoulders,  can  never  be  fully  realized  with- 
out a  thorough  education  in  anatomy  and  physiology.  And  if 
the  illustrations  here  presented  should  effect  the  needed  reform 
in  fashionable  dress,  the  resulting  health  and  happiness  to  the 
human  race  would  be  incalculable ;  for  the  health  of  the 
mothers  of  each  generation  determines,  in  a  very  large  mea- 
sure, the  vital  stamina  of  the  next. 


TIGHT-LACING. 


69 


"It  is  obvious  that,  if  the  diameter  of  the  chest,  at  its  lower 
and  broader  part,  is  diminished  by  lacing,  or  any  other  cause, 
to  the  extent  of  one-fourth  or  one-half,  the  lungs,  B,  B,  are 
pressed  in  towards  the 
heart,  A,  the  lower  ribs 
are  drawn  together  and 
press  on  the  liver,  C,  and 
spleen,  E,  while  the  ab- 
dominal organs  are  press- 
ed downward,  D,  on  the 
pelvic  viscera.  The 
stomach,  B,  is  compress- 
ed in  its  transverse  diam- 
eter; both  the  stomach, 
upper  intestines  and  liver 
are  pressed  downward  on 
the  kidneys,  M,  M,  and  f 
on  the  lower  portions  of 
the  bowels  (the  intestinal 
tube  is  denoted  by  the 
letters,  yy,  and  k),  while 
the  bowels  are  crowded 
down  on  the  uterus,  t, 
and  bladder,  g.  Thus 
every  vital  organ  is  either 
functionally  obstructed  or 
mechanically  disordered, 
*  and  disease,  more  or  less 
aggravated,  the  condition 
of  all.      In  post-moriem 

examinations  the  liver  has  Fig.  35.— Internal  Viscera. 

been  found  deeply  indented  by  the  constant  and  prolonged 
pressure  of  the  ribs,  in  consequence  of  tight-lacing. 

M  The  brain-organ,  protected  by  a  bony  inclosure,  has  not  yet 
been  distorted  externally  by  the  contrivances  of  milliners  and 
mantua-makers  ;  but,  lacing  the  chest,  by  interrupting  the  cir- 
culation of  the  blood,  prevents  its  free  return  from  the  vessels 


70 


DIGESTION. 


of  the  brain,  and  so  permanent  congestion  of  that  organ,  with 
constant  liability  to  headache,  vertigo  or  worse  affections,  be- 
comes a  ' '  second  nature.  And  this  condition  is  often  aggra- 
vated by  heavy  water-falls,  chignons  and  other  ridiculous  head- 
gear. 

"  The  vital  resources  of  every 
person,  and  all  available  pow- 
ers of  mind  and  body,  are 
measurable  by  the  respiration. 
Precisely  as  the  breathing  is 
lessened,  the  length  of  life  is 
shortened  ;  not  only  this,  but 
life  is  rendered  correspondingly 
useless  and  miserable  while  it 
does  exist. 

"It  is  impossible  for  any 
child,  whose  mother  has  dimin- 
ished her  breathing  capacity  by 
lacing,  to  have  a  sound  and 
vigorous  organization.  If  girls 
will  persist  in  ruining  their 
vital  organs  as  they  grow  up  to 
womanhood,  and  if  women 
will  continue  this  destructive 
habit,  the  race  must  inevitablj 
deteriorate.  It  may  be  assert- 
ed, therefore,  without  exaggera- 
tion, that  not  only  the  welfare 
of  the  future  generations,  but 
the  salvation  of  the  race  de- 
pends on  the  correction  of  this  evil  habit. 

4  4  The  pathological  consequences  of  continued  and  prolonged 
pressure  on  any  vital  structure  are  innutrition,  congestion, 
inflammation  and  ulceration,  resulting  in  weakness,  waste  of 
substance  and  destruction  of  tissue.  The  normal  sensibility 
of  the  part  is  also  destroyed.  No  woman  can  ever  forget  the 
pain  she  endured  when  she  first  applied  the  corsets ;  but  in 


Fig  36 — Anterior  View  of  the  Tho- 
rax in  the  Venus  of  Medicis. 


TIGHT-LACING. 


71 


time  the  compressed  organs  become  torpid ;  the  muscles  lose 
their  contractile  power,  and  she  feels  dependent  on  the  me- 
chanical support  of  the  corset.  But  the  mischief  is  not  limited 
to  local  weakness  and  insensibility.  The  general  strength  and 
general  sensibility  correspond  with  the  breathing  capacity.  If 
she  has  diminished  her  ' '  breath  of  life,"  she  has  just  to  that 
extent  destroyed  all  normal  sensibility.  She  can  neither  feel 
nor  think  normally.  But 
in  place  of  pleasurable 
sensations  and  ennobling 
thoughts,  are  an  indescriba- 
ble array  of  aches,  pains, 
weaknesses,  irritations,  and 
nameless  distresses  of  body, 
with  dreamy  vagaries,  fitful 
impulses  and  morbid  senti- 
mentalities of  mind. 

"  And  yet  another  evil  is 
to  be  mentioned  to  render 
the  catalogue  complete. 
Every  particle  of  food  must 
be  aerated  in  the  lungs  be- 
fore it  can  be  assimilated. 
It  follows,  therefore,  that  no 
one  can  be  well  nourished 
who  has  not  a  full,  free 
and  unimpeded  action  of  the 
lungs. 

' '  The  effects  of  improper 
dress  on  the  bony  skeleton, 
and  especially  on  the  spinal 
column,  are  shown  in  Figs. 
36,  37.  38,  and  39,  which  every  physician  knows  are  not  over- 
drawn. 

4 'In  the  contracted  chest,  represented  by  Fig.  37,  (by  nu 
means  an  uncommon  case),  the  external  measurement  is  re- 
duced one  half;  but  as  the  upper  portions  cf  the  lungs  cann«H 


Fig. 


37  — The  Same  in  a  Lady  Deformed 
by  Stays. 


72 


DIGESTION. 


be  fully  inflated  until  the  lower  portions  are  fully  expanded,  it 
follows  that  the  breathing  capacity  is  diminished  more  than 
one-half.    It  is  wonderful  how  any  one  can  endure  existence 

or  long  survive,  in  this  de- 
vitalized condition ;  yet  thou- 
sands do,  and,  with  careful 
nursing,  manage  to  bring 
into  the  world  several  sickly 
children. 

"The  spinal  distortion 
(  Fig.  39)  is  one  of  the  ordi- 
nary consequences  of  lacing. 
No  one  who  laces  habitually 
can  have  a  straight  or  strong 
back.  The  muscles  being 
unbalanced,  become  flabby 
or  contracted,  unable  to 
support  the  trunk  of  the 
body  erect,  and  a  curvature 
— usually  a  double  curva- 
ture— of  the  spine  is  the 
consequence. 

"And  if  anything  were 
needed  to  aggravate  the  spi- 
nal curvature,  intensify  the 
compression  of  the  internal 
viscera,  and  add  to  the  general  deformity,  it  is  found  in  the 
modern  contrivance  of  stilted  gaiters  These  are  made  with 
heels  so  high  and  narrow  that  locomotion  is  awkward  and  pain- 
ful, the  centre  of  gravity  is  shifted  'to  parts  unknown,'  and  the 
head  is  thrown  forwards  and  the  hips  projected  backwards  to 
maintain  perpendicularity,  rendering  walking  and  all  other 
voluntary  exercises  not  only  distressing  to  the  person,  but  dis- 
agreeable to  the  spectator. 

' '  To  sit  or  stand  in  a  crooked  position,  inclining  the  head  and 
knees  forwards,  overstretches  the  middle  spinal  muscles,  re- 
verses the  normal  curvature  of  the  spinal  column,  compresses 


Fig.  37.— Posterior  View  of  the  Thorax 

in  a>  -natural  state 


TIGHT-LACING. 


73 


the  liver,  stomach  and  lungs,  and  is  in  effect  equivalent  to  lac- 
ing the  waist.  Figs.  40  and  41  show  the  right  and  wrong 
positions  in  standing. 

"  Sleeping  on  two  or  three 
pillows,  or  on  a  bolster  and 
pillow,  is  a  prevalent  yet  per- 
nicious custom.  If  long  con- 
tinued the  effect  is  surely  a 
distortion  of  the  spine  to  some 
extent.  If  the  head  is  raised 
high  while  sleeping,  the  stom- 
ach and  lungs  are  injuriously 
compressed,  and  the  upper  in- 
testines pressed  downward  on 
the  pelvic  organs.  If  children  , 
are  allowed  to  sleep  habitually  j 
on  high  pillows,  spinal  curva- 
ture and  general  debility  will 
be  the  inevitable  conse- 
quences. One  pillow  is 
enough  for  any  person,  and 
that  should  be  only  of  mode- 
rate size.  Figs.  42  and  43 
exhibit  the  right  and  wrong 
positions  in  contrast. 

'  'Malpositions  in  sitting  seem 
to  be  among  the  increasing 
evils  of  high  civilization  without  physiological  education.  This 
habit  is  mainly  attributable  to  the  immensely  unanatomical 
construction  of  chairs,  benches,  sofas,  pews,  etc.  Not  one 
school-house  in  all  the  land,  not  excepting  those  in  which 
physiology  is  professedly  taught,  has  a  chair  or  a  bench  that  a 
child  can  sit  upright  on  without  a  constant  and  consciously 
painful  effort.  Nor  have  we  ever  seen,  in  private  families  or 
public  institutions,  halls  or  churches,  stages  or  ferry-boats,  rail- 
road cars  or  steamers,  a  single  seat  constructed  on  hygienic 


Fig.  39. — Distorted  Spine. 


"4 


DIGESTION. 


principles.    Figs.  44  and  45  show  the  normal  and  abnormal 

positions. 


Fig  40— Standing  Erect.  Fig.  41. — Malposition. 

Children  who  early  acquire  and  continue  in  the  habit  of  sit- 
ting in  normal  or  abnormal  positions  will  either  preserve  the 
erectitude  of  the  spinal  column  as  shown  in  Fig.  46,  or  become 
crooked-backed,  as  seen  in  Fig.  47. 

It  is  apparent  that,  inclining  the  head  forwards  and  bending 
the  body  at  the  middle  of  the  back,  instead  of  on  the  hip-joints, 
necessitates  a  backward  projection  of  the  entire  spinal  columnr 
with  a  corresponding  incurvation  or  pressure  anteriorily  ;  hence 
the  whole  body  is  distorted  from  the  crown  of  the  head  to 
the  soles  of  the  feet ;  more  than  a  hundred  muscles  are  un- 
balanced, and  every  organ  and  limb  is  weakened. 

In  all  exercises,  in  walking,  running,  lifting,  and  in  manual 
labor,  the  power  of  the  individual  is  always  determined  by  the 


POSITION. 


75 


number  of  muscles  that  are  brought  into  co-operative  action. 
But  if  the  body  be  crooked,  or  any  part  of  it  out  of  the  norma] 
relation  to  other  parts, 
some  muscles  will  be 
strained  by  over  ac- 
tion, while  others  will 
become  relaxed  from 
insufficient  action, 
and  all  weakened — 
just  as  in  the  crooked 
ways  of  society  some 
persons  are  drudged 
to  death  while  others 
die  of  indolence. 


Fig.  42. —Proper  Position  in  Bed. 


If  seats  were  pro- 
perly constructed  per- 
sons would  sit  up- 
right, for  the  reason 

that  it  would   be  the  Fig  43  —Improper  Position  in  Bed. 

most  comfortable  position.  It  would  be  painful  to  sit  other, 
wise.    The  chairs,  benches,  sofas,  pews  or  other  seats,  should 


Fig.  44  —Correct  Sitting  Position. 


Fig  45 — Misposition  in  Sitting 


76 


DIGESTION. 


fit  the  small  of  the  back,  the  curve  of  the  hips  and  the  whole 
length  of  the  thighs,  as  accurately  as  a  well-made  shoe  is  shaped 
to  the  foot,  or  harness  to  the  body  of  a  horse.    But  the  com- 


46— Natural  Spine.  47 — Distorted  Spine. 


mercial  articles  reverse  this  rule ;  they  press  unduly  on  the 
upper  part  of  the  thighs  and  the  upper  part  of  the  back,  and 
afford  no  support  whatever  where  it  is  principally  needed. 
Moreover,  in  addition  to  the  defective  shape,  they  are,  on  the 
average,  two  inches  too  high,  rendering  it  impossible  for  the 
feet  to  rest  evenly  and  easily  on  the  floor.  No  wonder  that,  on 
chairs  which  are  a  torment  to  one  who  tries  to  sit  erect,  per- 
sons are  continually  leaning  back  against  the  wall,  drawing 
up  their  feet,  placing  one  foot  across  the  opposite  knee,  brac- 
ing one  or  both  feet  against  the  chair  rounds  or  any  adjacent 
object,  and  getting  into  all  sorts  of  uncouth  and  ridiculous 
attitu  Jes. 

The  cut  (Fig  48)  represents  the  outline  of  our  ideal  chain 


POSITION. 


77 


7 


Fig.  48. 
The  Anatomical  Chair, 


We  place  it  on  record  for  the  benefit  of  the  future  generations,  in 
the  hope  that  some  ingenious  mechanic  or  pecunious  philan- 
thropist will  supply  one  of  the  great  wants 
of  the  age  by  introducing  it." 

As  normal  sensibility  is  intimately  con- 
nected with  respiration,  the  depression  and 
melancholy  so  common  to  dyspeptics  whose 
chests  are  contracted,  are  readily  accounted 
for.  Many  of  these  invalids  have,  by  tight- 
lacing  or  other  unhygienic  habits,  so 
changed  the  form  of  the  chest  as  to  render 
it  concave  in  front  where  it  should  be 
round  and  full,  thus  preventing  the  descent 
of  the  diaphragm  in  inhalation  and  ren- 
dering a  full  inflation  of  the  lungs  impos- 
sible. 

In  the  illustration  (Fig.  49), 
which  is  a  side  view  of  the  chest 
and  abdomen  in  respiration,  the 
importance  of  the  unimpeded  mo- 
tion of  this  muscular  structure 
which  divides  the  cavities  of  the 
thorax  and  abdomen  may  be  re- 
cognized at  a  glance. 

1.  Cavity  of  the  Chest.  2  Cavity  of  the  Ab- 
domen. 3.  Line  ol  direction  for  the  diaphragm 
when  relaxed  in  expiration.  4  Line  of  direc- 
tion when  contracted  in  inspiration.  5,  6  Posi- 
tion of  the  front  walls  of  the  Chest  and  Abdomen 
in  Inspiration   7,  8  Their  position  in  expiration 

The  careful  reader  will  now  have 
no  difficulty  in  understanding  why 
it  is  that  the  women  of  our  country 
are  so  much  more  dyspeptic,  as  a 

general  rule,  than  the  men,  and  SO  Fig.  49.  Action  of  the  Diaphragm. 

much  more  predisposed  to  consumption. 

I>et  us  complete  the  illustration  by  contrasting  the  forms  of 
features  of  one  who  has,  by  tight-lacing,  acquired  the  abnormal 


78 


DIGESTION. 


shape  of  the  chest,  with  its  necessary  accompaniment  of  a  wan, 
dejected,  and  expressionless  face,  (Fig.  50,)  and  a  '  'human 
form  divine,"  whose  breathing  capacity 
and  life-resources  are  shown  in  a  full 
expanded  respiratory  apparatus,  and  a 
correspondingly  vitalized,  hopeful,  and 
intelligent  countenance  —  such  as 
sculptors  and  painters  delight  to  fash- 
ion and  exhibit  in  marble  and  on  can- 
vas, and  such  as  admiring  crowds  will 
gaze  upon  for  hours  with  pleasure. 

Those  persons  who  are  distinguished 
as  having  a  "fine  flow  of  animal  spi- 
rits, "  invariably  have  a  free  play  of  the 
Fig.  50— Unnatural  Waist,  respiratory  system.  The  blood  being 
well  purified  and  the  food  elements  properly  aerated,  the  circu- 
lation is  well  maintained  on  the  surface,  and  the  patient  is  not 
disturbed  by  nor  sensitive  to  slight  changes  of  temperature,  nor 
chilled  with  an  easterly  wind  or  the  fog  of  a  morning,  as  is 
the  case  with  those  who  do  not  breathe  sufficiently.  And 
these  half-breathing  mortals  are  always  feeling  the  need  of 
some  artificial  support,  and  are  hence  more  liable  to  resort  to 
various  stimulating  viands  and  pungent  condiments,  which  only 
mitigate  their  sufferings  temporarily,  to  be  followed  by  collapse 
and  augmenting  debility. 

The  editor  of  a  monthly  periodical,  ("Hall's  Journal  of 
Health/')  some  years  ago  advanced  a  theory  on  the  relation  ot 
respiration  to  consumption  as  novel  as  it  was  absurd.  And  as 
the  author  has  written  a  book  on  consumption,  and  sells  medi- 
cines for  consumption  through  the  press,  and,  moreover,  as  his 
journal  has  attained  a  large  circulation,  and  is  often  quoted  as 
good  authority  by  country  newspapers,  his  ingenious  views  are 
worthy  of  a  passing  refutation. 

Briefly  stated,  the  new  and  original  theory  amounts  to  just 
this  :  1.  Consumption  is  tuberbulosis  of  the  lungs.  2.  Tu- 
berculation  of  the  lungs  usually  commences  in  the  upper  por- 
tion.   3.  A  due  expansion  of  the  lungs  prevents  the  formation 


POSITION. 


79 


of  tubercles.  Ergo,  By  constricting  the  lower  portion  of  the 
lungs,  as  by  tight-lacing,  the  upper  portions  of  the  lungs  are 
forced  to  do  the  breathing  which  the  lower  portions  are  pre- 
vented  from  doing,  and  hence  tight-lacing  and  such  other 
machinery  or  habits  as  diminish  respiration  in  the  lower  part 
of  the  lungs  are  remedial.  They  are  both  preventive  and 
curative  of  consumption. 

Ridiculous  as  this  reasoning  may  seem  to  any  tyro  in  physi- 
ology, it  has  appeared  so  plausible  to  some  invalids  that  they 
have  been  misled  by  it.  But  a  little  deeper  insight  into  the 
anatomy  and  physiology  concerned  will  at  once  dissipate  the 
delusion.  The  competent  physiologist  well  understands  that, 
in  the  act  of  respiration,  the  lower  portions  of  the  lungs  are 
always  expanded  before  the  upper  portions  can  be  filled  with 
atmospheric  air  ;  hence  whatever  tends  to  restrict  inhalation  in 
their  lower  portions  must  inevitably  diminish  still  more  the 
respiratory  capacity  of  the  upper  portions,  and  favor  tubercula- 
tion.  If  the  10,387  deaths  which  occurred  in  New  York  in 
1872,  of  the  four  diseases  most  immediately  connected  with 
respiration,  viz.,  consumption,  scrofula,  pneumonia,  and 
bronchitis,  a  large  proportion  of  whom  were  yaung  women,  do 
not  point  the  proper  moral  on  this  subject,  then  there  is  no  use 
in  mortuary  statistics. 

The  greater  prevalence  of  dyspeptic  and  consumptive  diseases 
among  women  than  men  has  caused  some  medical  writers  to 
theorize  that  the  explanation  is  to  be  found  in  original  frailty. 
But  the  contrary  is  true.  In  the  normal  condition  woman  has 
the  stronger  vital  and  nutritive  temperament,  and  is,  constitu- 
ionally,  less  predisposed  to  either  consumption  or  dyspepsia 
than  man.  There  is  a  necessity  and  a  reason  for  this.  She  is 
provided  by  nature  with  a  nutritive  apparatus  not  only  compe- 
tent to  nourish  and  sustain  her  own  structures,  but  also  able 
to  develop  and  nourish  offspring.  My  opinion  is,  that,  if  men 
would  dress  as  the  majority  of  women  in  fashionable  life  do, 
there  would  be  ten  cases  of  consumption  among  them  where 
there  is  one  now. 

Another  very  prevalent  source  of  dyspeptic  conditions  in 


8o 


DIGESTION. 


youth,  resulting  very  frequently  in  consumption  soon  after  ma- 
turity, if  not  before,  deserves  special  mention  in  this  place,  for 
the  special  reason  that  it  is  never  mentioned  in  medical  books, 
and  seldom  thought  of  by  parents  and  teachers.  I  mean  our 
common  schools.  We  are  accustomed  to  impute  our  progress, 
morality,  and  intelligence,  to  our  churches  and  schools.  This 
is  true,  with  some  grains  of  allowance.  But  these  drawbacks 
are  very  serious  ones.  Most  of  the  school-houses  in  our  cities, 
and  not  a  few  in  the  country,  are  pest-houses,  very  much  in 
the  sense  that  tenement  houses  are.  They  are  not  properly 
warmed  in  winter,  and  not  properly  ventilated  at  any  season. 
They  are  too  hot  or  too  cold  in  winter,  and  too  redolent  of 
miasm  in  the  summer.  The  scholars  cannot  get  fresh  air  in 
cold  weather  without  a  chilling  draft,  nor  pure  air  in  warm 
weather  under  any  circumstances.  Many  a  private  mansion, 
occupied  by  half-a-dozen  persons,  has  more  of  the  "  breath  of 
life  "  circulating  through  its  rooms,  than  have  some  of  our  ward 
school-houses  where  several  hundred  children  are  tortured  into 
"book  knowledge,"  at  the  expense  of  vitality.  As  the  air  in 
the  room  where  fifty  or  a  hundred  children  are  crowded  toge- 
ther, is  constantly  vitiated  by  the  exhalations  from  the  skin  and 
lungs,  it  is  impossible,  in  cold  weather,  to  ventilate  sufficiently 
from  the  doors  and  windows  without  rendering  the  atmosphere 
in  various  parts  of  the  room  too  variable  and  uneven  for  health. 
The  only  proper  method  of  warming  school-houses — and  the 
plan  is  equally  applicable  to  churches,  public  halls,  theatres, 
etc. — is  to  have  the  fresh  air  conveyed  from  the  outside  of  the 
building,  or  from  the  hall  within,  through  a  tube  or  pipe  under 
the  floor,  to  be  discharged  under  the  stove,  or  better  still,  into 
the  cylinder  or  air  box  adjoining  the  stove,  so  that  the  air  could 
be  warmed  before  being  diffused  through  the  room.  This 
arrangement  would  secure  a  uniform  temperature,  and  purify 
the  air  without  occasioning  unwholesome  or  even  unpleasant 
currents.  When  buildings  are  heated  by  steam  the  same 
arrangement  for  supplying  fresh  air  is  equally  desirable,  the 
outer  air  being  admitted  under  or  adjoining  the  radiating  coil 
or  plates. 


POSITION. 


81 


Moreover,  school-children  are,  as  a  rule  (I  know  of  no  ex- 
ceptions), made  to  "sit  still"  too  many  hours  in  the  day,  and 
on  unhygienic  seats  at  that.  Not  one  growing  child  in  ten  can 
be  confined  in  a  school  more  than  three  hours  a  day  without 
suffering  more  or  less  of  debility  and  endangering  life.  Our  sys- 
tem of  forced  education — developing  brain,  or  trying  to,  before 
there  is  a  physical  basis — is  all  wrong,  and  is  filling  the  land 
with  educated  imbeciles — I  mean  young  persons  who  have 
information  and  accomplishments,  but  are  useless  to  themselves 
and  a  burden  to  others,  because  of  ill-health.  I  regard  school- 
houses  as  among  the  worst  causes  of  the  general  frailty,  dys- 
peptic tendencies,  and  consumptive  sequaela  that  are  said  to  be 
peculiarly  A»  ttic  in. 


Abbor  Moeborum. 


DYS  P  EPSIA,. 


PART  II. 


DYSPEPSIA. 


CHAPTER  X. 
NATURE  OF  DYSPEPSIA. 

As  digestion  is  the  most  complex  of  all  the  organic  processes 
its  derangements,  which  constitute  indigestion,  or  dyspepsia, 
are  the  most  complicated  of  all  morbid  conditions.  Patho- 
logically it  may  be  said  to  be  the  sum  of  all  chronic  diseases, 
as  fever  may  be  said  to  be  the  aggregate  of  all  acute  diseases ; 
for  there  is  not  a  symptom  in  all  of  the  one  thousand  diseases 
which  make  up  the  nosology,  that  is  not  found  in  some  form, 
state,  or  stage,  of  both  dyspepsia  and  fever,  with  the  single 
exception  of  those  which  appertain  to  structural  lesions.  If  all 
the  "phenomenology"  which  the  confirmed  dyspeptic  experi- 
ences in  six  or  twelve  months  were  suffered  in  the  period  of 
twelve  or  twenty-four  hours,  the  disease  would  be  termed  fever, 
instead  of  dyspepsia  ;  and  if  the  symptoms  which  belong  to  a 
paroxysm  of  fever,  and  which  mark  its  cold,  hot,  and  sweating 
stages,  were  extended  over  a  period  of  some  weeks  or  months, 
the  disease  would  be  termed  dyspepsia  instead  of  fever.  In 
Doth  cases  the  inability  to  nourish  the  body  sufficiently  is  a 
leading  feature  of  the  morbid  manifestations  ;  but  in  fevers, 
properly  so  called,  the  power  of  digestion  and  assimilation  is 
wholly  suspended  in  the  early  stage,  while  in  dyspepsia  it  is 
only  impaired. 

It  is  a  great  mistake  to  regard  dyspepsia  as  peculiarly  or 
especially  a  disease  of  the  stomach.  We  have  seen,  in  the 
preceding  explanations  and  illustrations,  how  essentially co- 


NATURE  OF  DYSPEPSIA. 


*3 


operative  are  a  multitude  of  organs  and  structures  in  the  digestive 
processes.  And  they  are  just  as  co-implicated  in  the  derange* 
ment  of  these  processes.  In  some  cases  one  structure  or  organ 
will  be  more  obstructed,  impaired,  or  deranged  than  others,  and 
in  other  cases  two  or  more  will  be  the  seat  of  the  more  trouble- 
some symptoms.  Thus,  one  dyspeptic  may  have  one  of  several 
morbid  conditions  of  the  liver,  as  torpidity,  congestion,  indu- 
ration, chronic  inflammation,  gall-stones,  or  abscess,  as  the 
special  complication  of  his  case,  and  attended  with  jaundice, 
difficult  breathing,  or  palpitation,  a  sense  of  weight,  tenderness 
in  the  right  side,  spasms  near  the  pyloric  orifice,  or  throbbing 
pains,  as  the  most  prominent  symptom.  Another  will  have 
great  distress,  "  goneness,"  acrid  eructations,  sick  headache, 
a  cramp  in  the  stomach,  because  of  the  acid  and  putrescent  bile 
which  is  occasionally  emptied  into  the  duodenum  just  below 
the  pit  of  the  stomach.  A  third  may  have  constipated  bowels, 
and  a  fourth  diarrhoea,  and  a  fifth  these  states  interchangeably, 
as  the  most  troublesome  manifestation  of  the  general  ailment ; 
a  sixth  may  have  the  vessels  of  the  head  so  clogged  with  viscid 
blood  as  to  experience  more  headache,  either  constant  or 
periodical,  than  anything  else  to  complain  of;  a  seventh  may 
feel  great  distress  after  eating  ;  an  eighth,  frequent  paroxysms  of 
\nausea  and  vomiting  ;  a  ninth,  capricious  or  craving  appetite ;  a 
tenth  loss  of  all  appetite  ;  an  eleventh,  canker  in  the  mouth,  or 
stomatitis;  and  a  twelfth,  general  prostration,  hypochondria,  or 
nervous  debility,  as  the  more  distressing  part  of  his  case.  Many 
dyspeptics  suffer  in  all  of  these  ways,  and  have  the  symptoms 
\  above  enumerated  as  changeable  as  the  winds,  and  quite  as 
uncertain  with  regard  to  rules  for  calculation  as  the  weather 
"  probabilities." 

Medical  authors  generally  assign  "  weakness  of  the  stomach  " 
as  the  essential  proximate  cause  of  dyspepsia.  They  might  as 
well  say,  weakness  of  the  head,  or  heart,  or  hands,  or  feet ;  all 
are  weak  when  the  digestive  processes  fail  to  supply  the  ele- 
ments of  strength  ;  and  the  debility  of  the  stomach  or  other 
digestive  organs,  in  any  case  of  dyspepsia,  is  no  greater  and  no 
worse  than  that  of  all  other  parts  of  the  body.    Indeed,  the 


84 


DYSPEPSIA. 


difference  is  just  the  other  way,  for  nutrition,  being  the  first 
and  last  process  of  organic  life,  all  other  parts  of  the  system  are 
disproportionately  debilitated  when  the  digestive  function  is 
impaired.  Dyspepsia  is,  therefore,  but  a  name  for  universal 
physical  deterioration,  although  the  symptoms  of  the  general 
condition  may  embrace  all  the  aches,  pains  and  distresses  that 
our  language  can  express. 

The  error  of  regarding  dyspepsia  as  a  local  disease  instead  of 
a  constitutional  infirmity,  leads  to  the  mischievous  practice  of 
local  medication  ;  and  the  weak  stomach  is  excited  with  stimu- 
lants, urged  with  tonics,  soothed  with  nervines,  quieted  with 
opiates,  and  modified  with  alteratives,  while  the  other  "chy- 
loipcetic  viscera,"  especially  the  ever-involved  liver,  are  treated 
to  mercurials,  not  forgetting  to  remind  the  bowels  of  their  re- 
missness of  duty  by  a  succession  of  purgatives.  These  are 
excellent  methods  for  curing  dyspepsia  by  killing  the  patient, 
or  to  mitigate  symptoms,  by  destroying  vitality. 

Professor  George  B.  Wood,  M.  D.,  of  Jefferson  Medical 
College,  Philadelphia,  is  the  author  of  the  latest  and  largest 
American  work  on  the  Theory  and  Practice  of  Medicine.  In 
this  work  ("  Wood's  Practice  of  Medicine"),  which  is  a  text- 
book in  our  medical  colleges,  the  author  informs  us  that, 
"The  most  prolific  source  of  dyspepsia  is  probably  the  com- 
bined influence  of  sedentary  habits  and  errors  of  diet." 

This  being  the  case,  it  would  surely  seem  that  the  combined 
influence  of  appropriate  exercise  and  a  correct  dietary  ought  to 
be  the  sufficient  remedies.  The  Professor  does  indeed  tell 
many  things  useful  in  the  list  of  eatables  and  drinkables,  and 
some  articles  of  each  class  to  avoid,  but  the  strange  part  of  the 
story  is  that  he  recommends,  on  his  own  reputation,  or  com- 
mends on  the  opinion  of  other  authors,  in  the  treatment  of 
dyspepsia  and  its  incidental  affections,  no  less  than  a  dozen 
classes  of  medicines,  and  more  than  one  hundred  individual 
drugs,  to  say  nothing  of  the  unmentioned  ingredients  in  the 
compounds,  and  the  bleeding  and  blistering  processes. 

The  individual  remedies  are,  ipecacuanha,  rhubarb,  aloes, 
castile  soap,  croton  oil,  Cheltenham  salts,  Saratoga  water, 


NATURE  OF  DYSPEPSIA. 


(which  contains  no  less  than  ten  drugs)  sulphur,  mustard  seeds, 
magnesia,  quassia,  columbo,  gentian,  chamomile,  wild  cherry 
bark,  serpentaria,  carbonate  of  iron,  copperas,  carbonate  of 
soda,  carbonate  of  potassa,  powder  of  iron,  tincture  of  chloride 
of  iron,  iodide  of  iron,  chalybeate  mineral  waters,  oil  of  vitriol, 
aqua  fortis,  muriatic  acid,  nitro-muriatic  acid,  subnitrate  of 
bismuth,  white  vitriol,  lunar  caustic,  lactic  acid,  pepsin,  rennet, 
carbonic  acid  water,  creosote,  senna,  orange  peel,  cloves,  car- 
damom, fennel  seed,  mercurial  or  blue  pill,  calomel,  salt  (in 
the  form  of  a  warm  salt  bath),  opium,  mustard  plaster,  cayenne 
pepper  (in  the  stockings),  burgundy  pitch  (as  a  plaster),  ex- 
tract of  dandelion,  magnesia,  bicarbonate  of  soda,  lime  water, 
prepared  chalk,  prepared  oyster  shell,  carbonate  of  ammonia, 
aqueous  solution  of  ammonia,  aromatic  spirit  of  ammonia, 
powdered  charcoal,  compound  cathartic  pill  (composed  of 
several  drugs),  seidlitz  powder,  castor  oil,  mustard  sinapisms 
(over  the  stomach),  preparations  of  codeia,  leeching,  cupping, 
blisters,  tartar  emetic,  setons,  issues,  moxa  burnings,  henbane, 
stramonium,  deadly  night  shade,  extract  of  hemp,  lactucari- 
um,  chloroform,  prussic  acid,  tobacco  (smoking),  acetate  of 
morphia,  sulphate  of  morphia,  nux  vomica  (dogbane),  oxide 
of  zinc,  gallic  acid,  sulphate  of  quinia,  laudanum,  Hoffman's 
anodyne,  black  drop,  essence  of  peppermint,  essence  of  spear- 
mint, essence  of  pennyroyal,  ginger-tea,  compound  spirit  of 
lavender,  compound  tincture  of  cardamom,  oil  of  turpentine, 
bleeding  (in  some  cases  largely),  camphorated  tincture  of  opi- 
um, oil  of  horsemint,  lemon  juice,  common  salt,  epsom  salt, 
cinnamon,  brandy,  spiced  brandy,  spiced  wine,  sparkling 
wines,  extract  of  belladonna,  sulphite  of  soda,  strong  tea, 
coffee,  citrate  of  caffein,  cologne  water,  cider,  and  arsenite  of 
potassa. 

The  list  may  seem  very  formidable  at  the  first  count,  but  as 
the  remedies  are  all  directed  against  the  symptoms,  or  effects, 
and  none  of  them  against  the  causes,  and  as  the  symptoms  of 
dyspepsia,  in  all  of  its  multitudinous  forms  and  incidental 
affections,  embrace  the  whole  range  of  pathological  phenome- 
nology, the  list  might  be  extended  to  the  two  thousand  reme- 


86 


DYSPEPSIA. 


dies  of  the  drug  materia  medica,  as  well  as  limited  to  one  or 
two  hundred — provided  always,  that  drugs  are  the  proper 
remedies  for  dyspepsia. 

CHAPTER  XL 
SPECIAL  CAUSES  OF  DYSPEPSIA. 

It  is  true,  as  a  general  proposition,  that  whatever  impairs  the 
health  of  the  whole  system  or  any  part  of  it,  conduces  to  the 
condition  of  defective  nutrition  termed  dyspepsia.  But  there 
are  many  agents  and  influences  which  seem  to  derange  the  vital 
organism  more  prominently  or  more  immediately  in  the  primary 
nutritive  function,  which  may  properly  be  treated  of  as  the  spe- 
cial causes  of  dyspepsia.  It  is  these  agents  and  influences 
which  are  enumerated,  more  or  less  in  detail  in  medical 
books,  as  causes  of  dyspepsia. 

The  special  causes  of  dyspepsia  are  more  comprehensively 
and  clearly  stated  by  Dr.  John  Mason  Good  ("  Study  of  Medi- 
cine,") than  in  the  writings  of  any  later  author  with  which  I 
am  acquainted  : 

"  The  common  causes,  whether  confined  to  the  stomach,  or 
co-extensive  with  the  associate  viscera,  may  be  contemplated 
under  two  heads,  local  and  general.  The  local  remote  causes 
are,  a  too  large  indulgence  in  sedative  and  diluting  substances  ; 
as  tea,  coffee,  and  warm  water,  or  similar  liquids  taken  as  a 
beverage  ;  or  an  equal  indulgence  in  stimulant  and  acrid  mate- 
rials, as  ardent  spirits,  spices,  acids,  tobacco,  whether  smoked 
or  chewed,  snuffs,  a  daily  habit  of  distending  the  stomach  by 
hard  eating  or  drinking  ;  or  a  rigid  abstemiousness,  and  very 
protracted  periods  of  fasting.  The  general  remote  causes 
are,  an  indolent  or  sedentary  life,  in  which  no  exercise  is  afford- 
ed to  the  muscular  fibres  or  mental  faculties.  Or,  on  the  other 
hand,  habitual  exhaustion  from  intense  study,  not  properly 
alternated  with  cheerful  conversation  ;  becoming  a  prey  to  the 
Violent  passions,  and  especially  those  of  the  depressing  kind, 


SPECIAL  CAUSES  OF  DYSPEPSIA. 


87 


as  fear,  grief,  deep  anxiety  ;  immoderate  libidinous  indulgence, 
and  a  life  of  too  great  muscular  exertion.  Perhaps  the  most 
common  of  this  latter  class  of  causes  are,  late  hours,  and  the 
use  of  spirituous  liquors." 

There  is  one  prolific  cause  of  indigestion,  and  of  those  mos' 
distressing  complications,  obstinate  constipation,  pile  tumor.  , 
prolapsus  of  the  lower  bowel,  fistula  in  ano,  and  fissures  in  the 
rectum,  which  medical  authors  do  not  mention,  although  some 
of  them  allude  to  it  as  among  the  general  causes  of  indigestion. 
I  mean  purgative  or  cathartic  medicine,  regular  or  irregular. 
Torpid  or  inactive  bowels  is  so  nearly  a  universal  condition  in 
civilized  society,  that  purgative  medicine  of  some  kind  is  gene- 
rally regarded  as  necessary  as  is  food  or  drink.  And  people 
generally  regard  them  as  among  the  most  innocent,  or  at  the 
most,  the  least  injurious  of  the  various  classes  of  medicines. 
It  is  a  disastrous  mistake.  Bad  as  liquor  and  tobacco  are, 
purgatives  are  much  worse.  A  majority  of  persons  may  take 
an  ordinary  drink  or  dose  of  rum,  brandy,  gin,  or  whisky,  three 
times  a  day  with  less  injury  to  the  health,  than  are  doses  of 
jalap  and  cream  of  tartar,  senna  and  salts,  castor  oil,  or  any  of 
the  multitudinous  aperient,  purgative,  bilious,  or  anti-bilious 
pills  that  are  swallowed  by  hundreds  of  tons  annually. 

It  is  well  known  to  physicians  that  the  habitual  employment 
of  purgative  medicines  of  any  kind,  however  much  it  may 
relieve  temporarily,  never  fails  to  aggravate  constipation  in 
the  end.  I  have  had  patients  to  treat  whose  bowels,  after  being 
pilled  for  a  few  years,  would  not  move  without  special  attention, 
once  a  week.  In  one  instance  a  patient  came  to  me  from 
Europe  to  be  treated  for  constipation.  He  had  taken  cathar- 
tics regularly  for  a  dozen  years,  and  his  bowels  were  so  devital- 
ized that,  during  a  fifteen  days'  passage  across  the  Atlantic,  his 
bowels  did  not  move  at  all,  nor  did  he  experience  the  least  indi- 
cation in  that  direction.  Women  suffer  more  than  men  of 
purgative  medicines  because  their  more  sedentary  habits  seem 
to  require  larger  doses  or  more  frequent  repetitions. 

The  late  Professor  William  Tully,  M.  D.,  of  Yale  College, 
said  to  his  medical  class  that  more  injury  was  done  by  the 


88 


DYSPEPSIA. 


injudicious  use  of  cathartics,  by  the  regular  profession,  as  a 
whole,  than  by  all  other  classes  of  medicines. 

The  late  Professor  Robley  Dunglison,  M.  D. ,  in  his  work 
"Therapeutics  and  Materia  Medica,"  denounces  the  prevalent 
employment  of  cathartics  by  physicians  in  no  measured  terms  ; 
and  he  quotes  (Vol.  I.  page  176,)  the  eminent  Dr.  Stokes,  of 
London,  with  regard  to  their  use  in  fevers,  as  follows  : 

"A  common  practice  has  prevailed  in  these  countries,  and 
indeed,  still  exists  to  a  very  great  extent,  of  making  the  patient 
take  purgative  medicine  every  day ;  and  this,  I  regret  to  say, 
is  too  often  done  even  in  cases  where  the  surface  of  the  small 
intestine  presents  extensive  patches  of  ulceration.  Now,  I  will 
ask  you,  can  anything  be  so  barbarous  as  this,  or  can  it  be  ex- 
ceeded in  folly  or  mischief  by  the  grossest  acts  of  quackery  ? 
Here  we  have  an  organ  in  a  state  of  high  irritation,  and  exhib- 
iting a  remarkable  excitement  of  its  circulation,  and  yet  we 
proceed  to  apply  stimulants  to  that  organ,  and  to  increase  the 
existing  irritation.  Would  it  not  be  absurd,  in  a  case  of  in- 
flammation of  the  knee  or  elbow-joint,  to  direct  a  patient  to 
use  constant  exercise  and  motion  ?  Would  it  not  be  a  very 
strange  practice  to  apply  irritants  to  a  raw  and  excoriated  sur- 
face ?  Yet  something  equally  absurd  and  equally  mischievous, 
is  done  by  those  who  employ  violent  purgatives  in  a  case  of 
inflammation  of  the  digestive  tube  in  fever.  This  has  been  a 
great  blot  in  the  history  of  British  practice.  Calomel  and  black 
bottle,  and  even  jalap  and  aloes,  and  scammony,  have  been 
prescribed  for  patients  laboring  under  severe  and  extensive 
dothinenteritis.  Morbid  stools  are  discharged,  and  the  more 
morbid  they  are,  the  more  calomel  and  purgatives  does  the 
physician  give  to  change  their  character,  and  bring  them  back 
to  the  standard  of  health.  I  want  words  to  express  the  horrible 
consequences.  Too  often  have  I  seen  fever  patients  brought 
into  the  hospital  with  diarrhoea,  hypercatharsis,  and  inflamma- 
tion of  the  mucous  membrane  from  the  use  of  purgatives 
administered  before  their  admission.  Practitioners  will  not 
open  their  eyes.  They  give  purgatives  day  by  day,  a  very  easy 
practice,  and  one  for  which  there  are  plenty  of  precedents ;  but 


SPECIAL  CAUSES  OF  DYSPEPSIA. 


89 


it  is  fraught  with  most  violent  consequences.  I  will  freely  admit, 
that  the  disciples  of  the  school  of  Broussais  have  gone  too  far  in 
decrying  the  use  of  laxatives  altogether.  But  if  they  have  lost 
hundreds  by  this  error,  British  practitioners  have  killed  thousands 
by  an  opposite  plan  of  treatment.  In  cases  of  fever  where 
there  is  no  decided  symptom  of  gastro-enteric  disease,  there 
can  be  no  objection  to  the  use  of  laxatives,  if  required,  but  they 
should  always  be  of  the  mildest  description.  You  will  gain 
nothing  by  violent  purging  in  fever ;  mild  laxatives  alone  can 
be  employed  ;  and  where  there  is  any  sign  of  intestinal  irrita- 
tion present,  even  these  should  be  used  with  caution.  There 
is  one  mode  of  opening  the  bowels,  which  you  may  always  have 
recourse  to  with  advantage  in  fever,  viz.,  the  use  of  enemata. 
There  is  not  the  slightest  doubt  that,  occasionally,  accumu- 
lations of  fecal  matter  will  take  place,  and  tend  to  keep  up  irri- 
tation, but  they  should  always  be  removed  with  the  least  pos- 
sible risk  of  producing  bad  consequences.  To  purge  in  fever 
when  intestinal  irritation  is  present  is  a  practice  opposed  alike 
to  theory  and  experience,  and  I  have  already  stated  that  its 
results  are  most  horrible." 

All  the  reasons  which  Dr.  Stokes  presents  so  forcibly  against 
the  employment  of  cathartic  drugs  in*  fevers,  applies  with  still 
greater  emphasis  against  their  employment  in  dyspepsia,  for  the 
reason  that,  in  fevers,  the  points  of  irritation  are  more  diffused 
throughout  the  system,  whereas  in  dyspepsia  they  are  more 
concentrated  along  the  tract  of  the  alimentary  canal. 

The  late  Professor  Charles  A.  Lee,  M.  D.,  in  some  editorial 
notes  to  Copland's  Medical  Dictionary,  pages  385  and  386, 
makes  a  fearful  and  yet  most  truthful  statement  of  the  pills  and 
other  causes  now  in  operation  to  extend  and  perpetuate  dyspep- 
sia among  the  people  of  the  United  States.  There  is  food  for 
reflection  in  the  following  paragraphs  : 

"  Dyspepsia  is,  comparatively,  a  modern  disease  in  our 
country,  having  been  scarcely  known  until  within  the  last  thirty 
years  (1846).  Our  ancestors,  as  stated  by  an  accurate 
observer,  were  accustomed  to  much  bodily  exertion  ;  there 
were  but  few  pleasure  or  wheel-carriages  in  the  country ;  both 


DO 


DYSPEPSIA. 


males  and  females  generally  rode  on  horseback  ;  professional 
men  almost  universally  had  farms,  on  which  they  labored  more 
or  less ;  merchants  were  also  frequently  engaged  in  mechanical 
pursuits  ;  the  habits  of  living  were  simple  and  frugal  ;  intoxi- 
cating liquors  were  seldom  drunk  ;  religious  excitements,  so 
destructive  to  the  health  both  of  body  and  mind,  were  almost 
unknown  ;  regular  and  natural  hours  of  sleeping  and  eating 
were  observed  ;  and  these  circumstances  proved  highly  propi- 
tious in  securing  the  general  enjoyment  of  bodily  health  and 
mental  vigor.*  These  salutary  habits,  however,  have  been 
gradually  exchanged  for  those  of  a  more  unnatural  and  injuri- 
ous tendency  ;  bodily  labor,  carried  to  the  point  of  fatigue,  is 
now  deemed  degrading,  if  not  decidedly  vulgar  ;  languishing 
in  easy  carriages  has  succeeded  to  equestrian  habits  and  equita- 
tion ;  professional  men  confine  themselves  to  the  legitimate 
business  of  their  calling  ;  excitements  of  every  kind,  civil, 
political,  religious,  mesmeric,  are  the  order  of  the  day ;  habits 
of  luxurious  living  have  become  general  ;  alcoholic  drinks 
are  more  extensively  used  than  formerly,  although  a  great 
improvement  has  taken  place  within  the  last  few  years  ;  the 
almost  universal  practice  prevails  of  using  tobacco  in  some  form; 
habits  of  inactivity,  tight-lacing,  keeping  late  hours,  &c,  are 
gradually  undermining  the  health  of  the  female  sex,  and  lay- 
ing the  foundation  of  gastric  affections  ;  and  all  these  causes, 
with  numerous  others  that  might  be  named,  are  slowly  deteri- 
orating the  health  of  the  community,  and  their  effects  are 
likely  to  become  still  more  evident  and  distressing  in  the  next 
and  succeeding  generations. " 

How  fearfully  the  prediction  has  been  realized,  as  any  one 
may  see  in  the  skeleton  forms,  gaunt  abdomens,  caved-in 
chests,  projecting  shoulders,  wan  complexions,  dyspeptic  walk, 
and  consumptive  look  of  the  fashionable  young  ladies  and 
gentlemen  who  promenade  the  thoroughfares  of  our  great 
cities.    Of  the  pill  business,  Professor  Lee  says  : 

"  Another  very  prominent  cause  of  the  prevalence  of  indi- 

*  "A  Dissertation  on  Chronic  Debility  of  the  Stomach,  by  Benjamin  Wolsey  Dwight, 
in  Memoirs  of  the  Connecticut  Academy  of  Arts  and  Sciences.    New  Haven,  llxj." 


SPECIAL  CAUSES  OF  DYSPEPSIA. 


91 


gestion  in  this  country  is  the  excessive  use  of  cathartic  medi- 
cine in  the  form  of  pills.  Were  we  to  give  the  amount  of  the 
latter  annually  swallowed  in  the  United  States,  the  statement 
would  not  be  believed  ;  and  yet  we  have  it  from  good  authority, 
namely,  that  of  the  manufacturer  himself,  that  one  establish- 
ment in  the  city  (New  York, )  turns  out,  by  the  aid  of  steam, 
no  less  than  ten  barrels  per  day,  and  this  is  by  no  means  so 
extensive  as  some  others  of  a  similar  kind.  These  pills,  which 
are  highly  drastic,  are  used  by  immense  numbers  of  people, 
not  only  in  cases  of  actual  illness,  but  in  time  of  health,  as 
prophylactic  remedies.  The  consequences  are  easily  predicted. 
In  addition  to  this,  great  quantities  of  bitters  are  used,  in 
which  brandy,  wine,  or  some  alcoholic  liquor  forms  the  princi- 
pal ingredient ;  and  on  the  occurrence  of  the  least  feeling  of 
discomfort,  recourse  is  had  to  the  panacea,  till  at  length  the 
powers  of  the  stomach  are  exhausted,  and  derangements  either 
functional  or  structural  take  place.  We  could  wish  that  the 
epitaph  of  the  Italian  count  could  be  placed  so  as  to  be  seen 
by  every  man,  woman,  and  child  :  '  /  was  well — wished  to  be 
better — took  physic,  and  died.' 

"  Much  of  this  evil  is  doubtless  owing  to  physicians,  who  have 
been  too  much  in  the  habit  of  pouring  down  drugs  empirically 
in  every  case  of  illness,  slight  or  severe,  in  order  to  humor  a 
popular  notion  that  the  materia  medica  must  furnish  a  remedy 
for  every  disease,  and  a  popular  prejudice  that  want  of  success 
is  a  sure  indication  of  poverty  of  resource  on  the  part  of  the 
practitioner." 

A  little  figuring  will  give  us  a  more  realizing  sense  of  the 
extent  to  which  the  people  are  pilled.  Our  population  has 
doubled  since  Dr.  Lee  wrote  the  above,  and  pill-makers  have 
multiplied  ;  and  as  there  could  not  have  been  less  than  half-a- 
dozen  establishments  in  a  single  one  of  our  cities,  manufactur- 
ing each  ten  barrels  per  day,  the  quantity  now  made  daily  can- 
not be  less  than  one  hundred  barrels  per  day  ;  and  then  Phila- 
delphia does  an  extensive  business  in  the  same  line,  as  do 
Boston  and  other  cities.    But,  reckoning  the  pills  turned  out 


92 


DYSPEPSIA. 


in  the  city  of  New  York  alone,  let  us  see  how  the  mattel 
stands,  Pills  vs.  People. 

A  barrel  of  pills  will  weigh  about  as  many  pounds  as  a  bar- 
rel of  pork,  and  a  pill  of  average  size  three  and  a  half  grains. 
From  this  data  the  expert  in  arithmetic  may  soon  ascertain  that 
the  good  people  of  this  enlightened  nation  are  provided  with 
the  bowel-moving  agencies  of  fifteen  billion  nine  hundred  and 
ninety-one  million,  six  hundred  thousand  individual  pills  annu- 
ally. But  our  statistics  thus  far  represent  only  the  irregular 
trade.  If  we  add  the  pills  orthodoxically  prescribed,  we  may 
swell  the  amount  to  twenty  billions — two  billions  of  pills  for 
each  million  of  our  population,  or  five  hundred  pills  for  every 
man,  woman,  and  child.  And  yet  our  ciphering  is  not  com- 
plete. Young  children  cannot  swallow  pills  ;  there  are 
Homoeopathists  who  do  not  believe  in  them,  and  Hygienists 
who  never  take  medicine  of  any  kind  ;  hence  a  nice  calculation 
may  allow  the  actual  pill-takers  about  one  thousand  a  year  each, 
averaging  within  a  fraction  of  three  pills  per  day.  How  long  the 
human  stomach  and  bowels  can  stand  this  pill-trade  is,  like 
the  problem  of  the  final  consummation  of  all  things,  only  a 
question  of  time.  The  fact  that  our  people  '  '  still  live  "  under 
it,  is  a  sufficient  demonstration  that  " humanity  %s  tough." 
Such  a  treatment  of  our  domestic  animals  would  exterminate 
them  in  a  single  generation. 

In  a  late  work  on  Indigestion,  by  Arthur  Leared,  M.  D., 
extracts  from  which  appear  in  the  Popular  Science  Monthly  for 
May,  1872,  the  following  remarks  are  made  in  relation  to  the 
most  prominent  causes  of  dyspepsia  : 

"At  all  stages  of  adult  life,  but  particularly  during  its 
decline,  the  appetite  is  over-stimulated  by  condiments,  and 
tempted  to  excess  by  culinary  refinements.  Dyspepsia  is  not 
the  worst  result  of  this.  Gout,  and  still  more  serious  mala- 
dies connected  with  an  impure  state  of  the  blood,  closely 
follow." 

"Two  habits,  smoking  and  taking  snuff,  require  special 
notice  as  causes  of  dyspepsia.  Excessive  smoking  produces 
si  depressed  condition  of  the  system,  and  a  great  waste  of 


SPECIAL  CAUSES  OF  DYSPEPSIA. 


93 


saliva,  if  the  habit  of  spitting  is  encouraged.  I  have  met  some 
severe  cases  of  dyspepsia  clearly  resulting  from  these  causes. 
Some  individuals  are  unable  to  acquire  the  habit  of  smoking 
even  moderately.  Deadly  paleness,  nausea,  vomiting,  inter- 
mittent' of  pulse,  with  great  depression  of  the  circulation, 
come  on  whenever  it  is  attempted.  But  this  incapacity  is 
exceptional,  and  so  universal  is  the  desire  for  tobacco,  that  it 
seems  as  if  some  want  of  the  system  is  supplied  by  its  use." 

What  is  the  ' '  excessive "  use  of  tobacco,  or  any  other 
poison  ?  One  might  as  well  talk  of  excessive  lying,  or  excess- 
ive stealing,  as  though  moderation  in  these  habits  might  be 
judicious,  or  necessary  !  Nor  does  the  great  number  that 
have  depraved  their  instincts  and  become  addicted  to  tobacco- 
using,  make  the  vice  a  virtue.  As  well  might  the  general 
prevalence  of  gambling  or  prostitution,  in  any  given  locality 
(Wall  Street,  Five-Points),  be  adduced  as  the  evidence  that 
gambling,  or  prostitution  supplied  some  want  of  the  system. 
And,  verily,  it  does.  But  it  is  the  craving  of  a  demoralized 
mental  or  a  debauched  physical  nature. 

It  seems  quite  impossible  for  a  modern  medical  author  to 
write  anything  about  tobacco  or  alcohol  without  doing  it  with 
the  "modern  improvements''  of  logic.  He  knows  they  are 
bad.  He  knows  the  people  are  very  much  addicted  to  them. 
He  cannot  stultify  himself  by  saying  they  are  not  injurious. 
He  cannot  stultify  his  business  by  saying  they  are  wholly  evil, 
and  that  continually.  And  so  he  compromises  by  condemn- 
ing their  excessive  and  commending  their  moderate  employ- 
ment, leaving  his  readers  to  find  out  where  moderation  ends 
and  excess  begins — in  the  grog-shop,  the  gutter,  or  the  drunk- 
ard's grave,  if  they  can. 

Winslow's  Soothing  Syrup. 

Perhaps  no  single  quack  nostrum  is  doing  more  mischief  in 
our  country  at  this  time,  in  deranging  the  digestive  organs  of 
infants,  paralyzing  their  nerves,  stupefying  their  intellects, 
and  laying  the  foundation  for  dyspeptic  miseries  and  mental 


94 


DYSPEPSIA. 


imbecilities  in  later  life,  than  this  pernicious  opiate.  The 
Druggists  Circular  says  : 

"Mrs.  Winslow's  Soothing  Syrup  has  several  times  been 
condemned  in  the  columns  of  The  Druggists'  Circular,  but 
we  have  not  published  the  formula.  The  original  recipe  is 
kept  secret,  but  the  results  of  analysis  have  been  made  known. 
It  has  been  shown  that  one  ounce  of  the  syrup  contains  one 
grain  of  morphia.  If,  then,  Mrs.  Winslow's  instructions  be 
followed,  the  dose  for  an  infant  three  months  old  contains  an 
equivalent  of  ten  drops  of  laudanum,  and  this  Mrs.  Winslow 
recommends  to  be  repeated  every  two  hours  !  The  injury  that 
may  be  done  by  the  ignorant  use  of  such  a  nostrum  is  hardly 
to  be  estimated  ;  and  yet  a  calculation  has  been  made  that  not 
less  than  fifteen  million  ounces  of  the  syrup  are  annually  sold 
in  the  United  States  ;  in  other  words,  that  the  children  of  this 
country  are  dosed  every  year  with  as  many  million  grains  of 
morphia !" 


CHAPTER  XII. 

SYMPTOMS  OE  DYSPEPSIA. 

As  already  stated,  the  symptoms  of  dyspepsia  are  as  numer- 
ous and  as  complicated  as  are  morbid  conditions  and  abnormal 
sensations.  In  number  and  severity  they  vary  infinitely,  some 
dyspeptics  being  able  to  attend  to  their  ordinary  business  and 
duties,  and  only  experiencing  occasional  pain  or  distress  in  the 
stomach  or  auxiliary  digestive  organs,  while  others  are  unable 
to  do  anything  but  dwell  despondently  on  their  miserable  feel- 
ings, and  are,  indeed,  as  wretched  as  human  nature  can  bear 
and  live. 

The  symptoms  attending  the  more  important  phases  of  the 
disease  have  been  explained  in  connection  with  the  organs  and 
structures  to  whose  special  functional  disturbance  they  are 
more  particularly  referable,  in  the  first  part  of  this  work.  I 


SYMPTOMS  OF  DYSPEPSIA. 


95 


will  only  add  the  description  of  Dr.  Good,  whose  admirable 
work,  though  not  now  a  text-book  in  our  medical  colleges,  is 
a  vastly  more  useful  work  for  the  medical  student  or  the  non- 
professional reader,  than  any  work  on  the  Theory  and  Practice 
of  Medicine  that  has  appeared  since. 

"  Dyspepsia  may  be  regarded  as  consisting  of  the  combina- 
tion of  several  morbid  conditions,  irregularly  intermixed  ; 
sometimes  one  set  of  symptoms  taking  the  lead,  and  some- 
times another  ;  with  a  peculiar  tendency  to  costive  bowels,  and 
especially  that  species  of  costiveness  dependent  on  a  weakly 
temperament  or  a  sedentary  habit,  and  in  which  the  discharged 
foeces,  instead  of  being  congestive  and  voluminous,  are  hard, 
slender,  and  often  scybalous.  Dyspepsia,  therefore,  in  the 
language  of  Dr.  Cullen,  may  be  described  as  a  want  of  appetite, 
a  squeamishness,  sometimes  a  vomiting,  sudden  and  transient 
distentions  of  the  stomach,  eructations  of  various  kinds,  heart- 
burn, pains  in  the  region  of  the  stomach,  and  a  bound  belly. 
Yet  none  of  these  are  universally  present,  and  all  of  them 
seldom.  So  that,  as  already  observed,  the  symptoms  of  car- 
dialgia,  flatulence,  and  vomiting,  with  a  few  others,  enter  in 
irregular  modifications  into  dyspepsia,  as  those  of  dyspepsia 
enter  into  hypochondriasis. 

' '  There  is  also  another  complaint  which  frequently  enters 
into  the  multiform  combination  of  maladies,  of  which  dyspep- 
sia is  the  general  expression,  and  which  has  been  rarely  noticed 
by  writers,  although  it  is  often  a  very  troublesome  symptom, 
and  that  is  gravel.  In  treating  of  gravel,  or  lithia,  as  an 
idiopathic  affection,  we  shall  have  to  notice  that  one  of  its 
chief  and  most  common  causes  is  an  excess  of  acidity  in  the 
prima  vice ;  and,  as  such  excess  is  almost  constantly  to  be 
found  in  dyspepsia,  gravel  must  frequently  attend  or  follow, 
and  is  even  a  necessary  effect  where  there  exists  what  has  been 
called  a  calculous  diathesis.  And,  for  a  like  reason,  where 
there  is  a  podagric  diathesis,  gout,  in  some  form  or  other,  is  a 
frequent  concomitant/' 

1  'In  dyspepsia  the  debility  is  not  often  confined  to  the 
stomach,  but  extends  to  the  intestinal  canal,  and  the  collati- 


96 


DYSPEPSIA. 


tious  viscera,  as  the  mesentery,  the  spleen,  the  pancreas,  <uid 
especially  the  liver,  in  which  it  most  frequently  commences ; 
and  hence  another  cause  of  the  great  complexity  of  this  disease. " 

' 'The  debility,  and  indeed  torpitude  of  the  intestinal  canal, 
is  evident  from  the  habitual  costiveness  which  so  peculiarly 
characterizes  this  affection.  Whether  this  be  direct  or  indirect* 
intrinsic  or  sympathetic,  as  harmonizing  with  the  weakness  of 
the  stomach,  it  is  not  easy  to  determine  ;  but  nothing  can  be 
a  stronger  proof  of  the  great  inactivity  of  the  intestinal  tube, 
from  whatever  cause  produced,  than  the  feebleness  of  its 
peristaltic  motion,  notwithstanding  the  acrimonious  matters 
that  are  so  frequently  diffused  over  its  inner  surface." 

"The  imbecility  of  the  liver  is  equally  obvious  in  most 
cases,  from  the  small  quantity  of  bile  that  seems  to  be  excreted, 
or  its  altered  and  morbid  hue,  as  evinced  by  the  color  of  the 
foeces,  which,  in  some  instances,  are  of  an  unduly  dark,  and 
in  others  of  an  unduly  light  tint ;  and  possibly  from  the  inac- 
tivity of  the  intestines  themselves,  whose  peristaltic  motion  is 
conceived  by  Dr.  Saunders  and  other  pathologists  to  be,  in  a 
great  measure,  kept  up  by  the  stimulus  of  the  bile.,; 

"When  the  mesentery  is  affected  the  chyle  is  generally 
obstructed  in  its  passage  to  the  thoracic  duct,  and  the  general 
frame,  deprived  of  its  needful  nutrition,  becomes  flaccid  and 
emaciated  ;  and  from  a  collapse  of  the  minute  vessels  on  the 
surface,  assumes  a  wan  or  sallow  complexion." 

"It  is  highly  probable  that  the  pancreas  and  spleen  are 
both  also  affected  in  many  cases  of  dyspepsia.  Of  the  actual 
I  part  taken  by  either,  in  the  process  of  digestion,  we  know  but 
little ;  but  we  do  know  that  the  pancreas  pours  forth  a  con- 
siderable portion  of  the  fluid  which  holds  the  solid  part  of  our 
aliment  in  solution  ;  while  in  most  of  the  cases  of  dyspepsia 
brought  on  by  a  habit  of  drinking  spirituous  liquors,  the  spleen 
is  evidently  affected  as  well  as  the  liver. " 

"  It  is  in  this  stage  of  the  disease  that  we  frequently  meet 
the  tenderness  or  other  uneasiness  in  the  epigastric  region,  and 
that  peculiar  hardness  of  the  pulse,  often  accompanied  by 
febrile  symptoms,  which  Dr.  Wilson  Philip  has  pointed  out 


SYMPTOMS  OF  DYSPEPSIA. 


97 


as  pathognomonic  of  what  he  calls  a  second  stage  of  the  dis- 
ease. " 

"It  has  also  been  well  observed  by  Dr.  Philip,  that  the 
lungs  are,  in  many  instances,  apt  to  associate  in  the  morbid 
action  of  the  digestive  organs,  when  it  has  become  chronic, 
and  to  produce,  as  a  result,  a  peculiar  variety  of  consumption, 
to  which  he  has  given  the  name  of  dyspeptic  phthisis.  The 
dyspeptic  character  of  the  disease,  however,  and  especially  the 
hepatic  symptoms,  together  with  those  of  lowness  of  spirits, 
flatulence,  and  other  hypochondriacal  affections,  rarely  fail  to 
accompany  it  when  complicated  with  phthisis,  and  point  out 
its  real  source  ;  and  the  cure  must  be  chiefly  directed  to  the 
primary  malady,  how  much  soever  the  induced  symptoms  may 
also  demand  our  attention  ;  for  it  will  be  in  vain  to  subdue  the 
latter,  while  the  former  is  still  suffered  to  bear  sway." 

"It  must  nevertheless  be  admitted,  that  in  some  instances 
the  secondary  disease  seems  to  afford  relief  to  the  primary,  and 
that  the  organ  first  affected  recovers  its  health  in  proportion  as 
that  subsequently  affected  yields  to  the  attack  ;  in  the  same 
manner  as,  in  erysipelas  and  the  migratory  forms  of  herpes, 
the  eruption  travels  forward,  the  part  relinquished  heals,  and 
fresh  parts  are  affected  in  succession.  In  all  such  cases,  the 
secondary  complaint  becomes  a  new  malady,  and  must  often 
be  followed  up  under  another  principle  and  another  mode  of 
treatment. " 

"Under  whatever  form,  and  from  whatever  cause  the  disease 
occurs,  there  is  a  considerable  degree  of  general  languor  and 
debility.  Exercise  or  exertion  of  any  kind  soon  fatigues  ;  the 
pulse  is  weak  ;  the  sleep  disturbed  ;  the  extremities  are  cold, 
or  rendered  so  on  slight  occasions  ;  and  the  tongue  for  the 
most  part  is  fussed,  or  covered  with  a  creamy  mucus  in  the 
morning.  Yet  this  last  symptom  is  not  always  to  be  depended 
on  ;  for  it  is  sometimes  wanting  in  the  disease." 

"That  dyspepsia  should  be  connected  with  a  morbid  con- 
dition of  any  of  the  adjoining  organs,  is  by  no  means  difficult 
to  conceive,  when  we  reflect  that  they  are  all  concerned,  directly 
or  indirectly,  in  completing  the  great  object  of  the  digestive 


98 


DYSPEPSIA. 


process,  which  is  that  of  furnishing  a  constant  supply  of  nutri- 
tion for  the  system  at  large. " 

Not  half  a  century  ago,  it  became  a  fashion  with  some 
physicians,  in  obscure  and  complicated  cases  of  indigestion, 
when  diagnosis  was  dubious  and  prognosis  impracticable,  es- 
pecially after  the  patient  had  "  suffered  many  things  of  many 
physicians/'  to  request  the  patient  to  make  a  written  list  of  his 
symptoms,  as  they  occurred  from  day  to  day.  But  it  was  found 
to  work  like  Homoeopathic  ' '  provings. "  If  the  experimentee 
swallow  an  inappreciable  particle  of preparata  creta,  diluted  in, 
diffused  through,  or  potentized  by,  ten  thousand  trillion  times 
its  bulk  or  weight  of  water,  he  may  count  five,  fifty,  five  hun- 
dred, or  five  thousand  "symptoms,"  according  to  the  time 
and  attention  that  he  will  give  to  the  subject.  So  with  these 
miserable  dyspeptics,  made  more  miserable  by  the  miserable 
business  of  thinking  of  their  miseries.  There  was  no  end  to 
their  miserable  and  ever  changing  sensations.  The  moment 
a  confirmed  dyspeptic  undertakes  4 'to  see  how  he  feels,"  and 
make  a  record  of  his  morbid  sensations,  he  can  always  have  a 
day's  work  before  him.  He  can  write  down  symptoms  day 
after  day,  ' '  from  the  rising  of  the  sun  to  the  going  down  of 
the  same,"  besides  dreaming  of  them  half  the  night.  That 
inimitable  lithograph  of  equine  pathology,  on  sale  at  the  horse 
bazaars,  denominated  "The  Horse  with  all  Diseases, "  whose 
deformed  body,  distorted  joints,  dilapidated  surface,  abrasions, 
swellings,  ulcers,  and  emaciation  represent  sixty-four  distinct 
maladies,  does  not  indicate  more  phenomenology  than  almost 
any  dyspeptic,  who  has  been  cured  half  a  dozen  times,  can 
count  if  you  give  him  time  enough. 

Many  febrile  patients  are  drugged  into  chronic  diseases, 
which  invariably  present  some  one  or  more  of  the  numerous 
phases  of  dyspepsia  ;  and  many  of  the  worst  symptoms  of 
which  most  dyspeptics  complain,  are  nothing  more  nor  less 
than  the  effects  of  the  medicines  they  have  taken.  Women,  in 
this  respect,  suffer  much  more  than  men  do,  for  the  reason  that, 
being  more  dyspeptic,  they  are  doctored  more.  The  following 
remarks,  quoted  from  my  work  on  "The  Health  and  Diseases 


SYMPTOMS  OF  DYSPEPSIA. 


99 


of  Women,"  published  at  the  Health  Reformer  office,  Battle 
Creek,  Michigan,  will  apply,  with  some  qualification,  which 
the  reader  will  readily  appreciate,  to  men  as  well  as  women  : 

1 '  Drugging  during  Pregnancy.  — But  if  the  woman  escapes 
with  dear  life  the  ailments  incident  to  puberty,  other  perils  are 
before  her.  In  the  common  order  of  events,  the  matrimonial 
relation  is  formed.  Then  come  child-birth  and  nursing,  with 
all  their  joys  and  sorrows.  Lucky  is  the  woman  who  can,  on 
these  occasions,  escape  the  doctor's  lancet  and  drugs.  During 
pregnancy,  she  usually  suffers  more  or  less  of  nausea,  cramps, 
constipation,  vertigo,  etc.,  for  which  she  is  bled,  physicked,  and 
narcotized,  predisposing  her  to  hemorrhage,  milk-leg,  broken 
breast,  and  other  sequela,  and  multiplying  the  occasions  for 
taking  more  medicines. 

"  Drugging  during  the  Lying-in  Period. — After  confine- 
ment, the  majority  of  women  are  troubled  (and  no  wonder) 
more  or  less  with  indigestion,  constipation,  sour  stomach,  flat- 
ulence, sore  mouth,  sick  headache,  etc. ,  for  which  chalk,  soda, 
saleratus,  magnesia,  lunar  caustic,  bismuth,  blue  pill,  etc.,  are 
prescribed.  And  now  the  medicines  are  doing  a  double  work 
of  mischief.  The  drugs  which  she  is  continually  taking  into 
her  system,  under  the  name  of  medicine,  deprave  the  blood, 
vitiate  all  of  the  secretions,  and  poison  the  very  fountain 
whence  the  new-born  being  derives  its  nourishment. 

' 'These  drug  poisons  must  be  expelled.  The  living  system 
gets  rid  of  them  through  every  available  channel.  And  that 
portion  which  passes  off  with  the  milk  often  destroys  the  life  of 
the  nursing  infant,  or  renders  it  a  puny,  feeble  thing  for  life. 
So  much  for  the  child.  It  must  be  at  all  times  liable  to  can- 
ker, colic,  humors,  rashes,  convulsions,  and  death,  so  long  as 
its  mother  is  continually  taking  into  her  system  that  which  con- 
taminates and  impoverishes  the  only  source  of  its  subsistence. 

4 'Chronic  Drug  Disease. — But  if  the  mother  survive  the 
terrible  ordeal  which  a  false  medical  system  imposes  on  her, 
there  is  yet  trouble  enough  in  the  future.  The  dosings  of 
infancy,  the  druggings  of  puberty,  and  the  poisonings  of  her 
maternity,  have  laid  the  foundations  for  innumerable  and  name- 


100 


DYSPEPSIA. 


less  chronic  diseases;  and  now  these  must  be  doctored  secundem 
ariem.  And  thus  medical  science  has  laid  the  foundation  for 
an  extensive  practice  in  the  healing  art — provided  the  patient 
lives  long  enough. 

In  due  time  the  woman  comes  to  be  regarded  as  a  confirmed 
invalid.  And  no  sooner  is  she  "  cured  "  of  one  malady,  than 
another  "  sets  in. " 

How  strange  that  some  new  disease  is  always  ready  to 
"supervene  "  so  soon  as  the  existing  one  is  "subdued  !"  Her 
aches  and  pains,  and  "  sinking  spells,"  and  flutterings,  and 
gonenesses,  and  short  breathings,  and  palpitations,  and  dragging 
sensations,  and  nervousness,  require,  in  the  judgment  of  the 
family  physician,  a  course  of  tonics,  nervines,  and  stimulants, 
and  quassia,  carbonate  of  ammonia,  assafetida,  castor,  musk, 
valerian,  spices,  aromatics,  phosphate  of  iron,  or  iron-by-hy- 
drogen, wine,  brandy,  porter,  ale,  lager  beer,  etc. ,  etc. 

She  is  also  put  on  the  medico-slop  diet  of  the  pharmacopoeias 
— fed  on  such  delicate  abominations  as  panada,  starch  pud- 
dings, beef  tea,  mutton  broth,  oyster  soup,  chicken  gravy, 
buttered  toast,  and  sugar  nick-nacs.  In  a  word,  instead  of 
being  nourished  and  strengthened,  she  is  merely  stuffed  and 
stimulated. 

All  this  makes  a  bad  matter  worse;  and  at  length  the  doctor, 
having  treated  the  general  dyspeptic  condition  for  a  few  months, 
or  a  few  years,  looks  a  little  deeper  into  the  case,  and  finds  out 
that  the  patient  has  a  torpid  liver.  Then  come  calomel  and 
opium,  perhaps  blue  pill  again,  to  "touch  up"  the  hepatic 
function,  with  henbane,  or  conium,  or  morphia,  to  quiet  the 
irritation. 

Well,  in  due  time  the  torpid  liver  is  "  cured,"  or  its  action 
so  depressed  that  it  ceases  to  make  any  further  resistance  to  the 
medicines,  and  now  the  doctor  discovers  that  jaundice  has  ' 4  set 
in."  Verily  it  has.  And  the  drugs  are  just  what  have  set 
it  in. 

But  this  jaundice  must  be  "treated  ;"  and  so  the  persevering 
physician  doses  it,  or  the  patient,  with  a  combination  of  "  alte- 
ratives " — antimony,  hydriodate  of  potassa,  yellow  dock,  bitter 


SYMPTOMS  OF  DYSPEPSIA. 


lot 


sweet,  blue  flag,  mandrake,  black  cohosh,  corrosive  sublimate, 
iodine,  and  arsenic. 

And  thus  another  set  of  poisons  are  sent  into  the  vital  do- 
main, with  the  inevitable  result  of  another  set  of  drug  diseases. 

Soon,  another  diagnosis  is  made,  and  the  disease  is  pro- 
nounced kidney  complaint.  This  is  medicated  with  leeches, 
cuppings,  salts,  antiphlogistics,  diuretics,  alkalies  and  counter 
irritants,  and  the  next  phase  of  the  malady  is  said  to  be  nervous 
debility.  And  again  the  patient  must  be  put  on  tonics,  stimulants, 
and  nervines,  as  lunar  caustic,  phosphorus,  ammonia,  extract 
of  hops,  cascarilla,  myrrh,  hypophosphites,  preparations  of 
iron,  camphor,  ether,  spirits  of  nitre,  compound  spirits  of  la- 
vender, golden  seal,  unicorn,  wormwood,  thoroughwort,  skunk 
cabbage,  etc.,  etc. 

When  the  sensibility  of  the  nervous  system  is  sufficiently 
subdued,  the  nervous  debility  is  as  subdued  also.  The  disease 
is  "cured,''  though  the  patient  is  nearly  killed  ;  but  no  sooner 
is  the  cure  achieved  than  (how  unfortunate !)  still  another  dis- 
ease " supervenes.''  Now  the  muscular  system  gives  out ;  the 
back  becomes  weak,  and  the  limbs  tremulous.  The  kind  and 
ever-faithful  physician  now  diagnosticates  spinal  irritation.  Still 
he  is  not  without  hope  for  his  patient.  The  resources  of  his 
art  are  immense.  There  are  in  the  apothecary  shop  at  least 
one  thousand  drugs  which  he  has  not  yet  administered,  and 
there  are  numerous  processes  which  he  has  not  yet  brought 
into  requisition.  Why  should  he  be  discouraged?  So  long  as 
there  is  life  there  is  hope — at  least  of  making  a  bill. 

Blistering,  cupping,  leeching,  scarifying,  pustulations,  cau- 
stics, issues,  setons,  moxa  burnings  and  the  actual  cautery,  are 
the  scientific  remedies  for  spinal  irritation. 

The  marring,  and  scarring,  and  haggling,  and  mangling, 
finally  overcome  the  spinal  irritation,  and  then  we  come  to  the 
end  of  the  chapter,  which  is  neuralgia. 

Neuralgia  is  regarded  as  incurable.  But  there  is  one  conso- 
lation— there  aie  no  more  diseases  to  "set  in."  The  patient 
has  got  below  the  range  of  their  action,  and  hence  cannot  be 
*'  attacked  "  by  them.    Her  vitality  is  too  low  to  respond  to 


102 


DYSPEPSIA. 


morbific  causes,  hence  they  may  remain  in  her  system  without 
any  special  effort  to  get  rid  of  them.  She  cannot,  therefore, 
have  any  particular  disease  known  to  the  nosology,  but  she 
can  be  very  wretched. 

The  doctors  can  cure  almost  everything  except  neuralgia. 
We  have  seen  how  effectually  they  cure  dyspepsia,  liver  com 
plaint,  jaundice,  kidney  disease,  nervous  debility  and  spinal 
irritation,  but  neuralgia  is  peculiarly  a  "  medicorum  oppro- 
brium.,,  Yet  medical  science  does  not  wholly  despair,  it  can 
still  "alleviate  the  symptoms.''  For  what  did  "nature  pro- 
vide "  morphine,  quinine,  stramonium,  belladonna,  prussic 
acid,  veratria,  aconite,  chloroform,  digitalis,  henbane,  ratsbane, 
dogsbane,  fleabane,  and  all  the  banes,  venoms  and  viruses,  all 
the  drugs  and  die  stuffs,  and  dregs  and  scum  of  the  mineral, 
vegetable,  and  animal  kingdoms,  except  to  quiet  pain  ?  And 
so  long  as  the  poor  patient  is  dosed  with  narcotics  and  de- 
pressants below  the  point  of  susceptibility,  she  may  be  kept 
oblivious  of  misery.  Has  not  medicine  been  entitled  the  art 
divine?  I  fear  the  Irish  doctor  was  not  far  wrong  when  he 
presented  a  bill  to  his  wealthy  neighbor:  "To  curing  your 
wife  till  she  died. " 

And  now  after  medical  skill  has  done  its  best,  or  its  worst, 
surgical  ingenuity  exhausts  itself  in  vain  efforts  to  repair  the 
damages  occasioned  by  bad  living  and  worse  doctoring.  The 
uterine  organs  become  permanently  congested,  relaxed,  and 
debilitated,  ulcerations  occur,  excrescences  form,  and  displace- 
ments result. 

These  are  treated  indiscriminately  with  astringents,  caustics, 
pessaries,  braces,  leechings,  scarifyings  and  burnings,  which, 
although  in  some  cases  temporary  relief  is  obtained,  never  fail 
to  aggravate  the  difficulties  in  the  end. 

Induration,  paralysis,  fistulous  openings,  extensive  inflam- 
mations, permanent  adhesions,  fungous  excrescences,  and  can- 
cerous ulcerations,  are  among  the  frightful  catalogue  of  evils 
which  result  from  these  attempts  to  give  "  mechanical  support" 
to  the  displaced  viscera. 

Not  long  since,  I  had  a  patient  under  treatment  for  erosive 


SYMPTOMS  OF  DYSPEPSIA. 


103 


or  cancerous  degeneration  of  the  uterus,  the  consequence  of  the 
prolonged  employment  Of  pessaries.  And  a  few  years  ago,  I 
was  consulted  by  a  lady  who  had  a  fistulous  ulcer  opening  ex- 
ternally from  the  bowels,  just  below  the  umbilicus,  through 
which  the  fecal  matters  were  discharged,  produced  by  wearing 
an  "  abdominal  supporter," 

A  few  years  ago,  I  visited  a  young  lady  in  Philadelphia  who 
had  been  a  bed-ridden  invalid  for  fifteen  years,  in  consequence 
of  a  retroversion  of  the  womb.  Her  father  was  wealthy  and 
had  employed  the  most  eminent  physicans  and  surgeons  of  that 
doctor-making  city,  who  had  invented  a  bureau  drawer  full  of 
"supporters "  for  the  displaced  organ  ;  and  they  had  ' '  toned  her 
up  "  with  tonics,  and  "  quieted  her  down  "  with  nervines,  and 
nourished  her  on  "blood-food"  preparations  of  iron,  until  her 
muscular  system  was  as  flimsy  as  a  wet  rag.  And  these  are  but 
examples  of  hundreds  whose  cases  have  come  under  my  ob- 
servation and  treatment. 

I  cannot  pursue  this  branch  of  my  subject  here.  Those  who 
would  have  fuller  information  are  referred  to  my  larger  works, 
"Pathology  of  the  Reproductive  Organs,"  and  "Uterine 
Diseases  and  Displacements.  "  The  limits  of  this  work  will 
only  enable  me  to  show  the  errors  and  absurdities  of  the 
prevailing  medical  system,  and  indicate  "the  better  way." 

As  future  generations  may  prosper  or  must  perish,  just  as 
the  mothers  of  the  race  maintain  or  lose  their  vital  stamina,  I 
cannot  forbear  copying  the  following  appeal  to  Christians, 
from  that  excellent  monthly,  The  Christian  Monitor.  It  ought 
to  be  distributed  as  a  tract  in  every  Sunday-school  in  the  land  : 

THF  PRIME  CAUSES   OF  WOMAN  S  SUFFERINGS. 

BY  JOSSI  ANN  MAI. 

The  principle  of  progression  in  human  nature  furnishes  the  proposition 
"  that  it  is  not  the  goal,  but  the  course  which  makes  us  happy  " — not  so 
much  the  possession  of  an  object  as  the  pursuit  that  gives  pleasure.  If  this 
is  true,  it  is  also  true,  that  a  consciousness  that  one's  course  will  not  secure 
the  object  sought,  will  incur  great  discomfiture  and  its  consequent  evils  ; 
for  while  the  attainment  of  earthly  prizes  do  not  satisfy,  they  lure  us  on, 
compensating  and  withholding  in  advance  according  to  the  course.  Life 
&  repetition  of  causes  an4  effects,  of  efforts  and  rewards,  or  punishments, 


104 


DYSPEPSIA. 


which  are  but  the  tiny  ripples  of  its  sea,  that  must  widen  and  extend  into 
corresponding  shapes  in  the  great  ocean  of  eternity  for  all  its  possessors. 

We  do  not  advocate  the  doctrine,  that  a  man's  temporal  life  on  earth, 
antetypes  his  employment  in  heaven  ;  but  we  do  believe  that  the  degree  of 
moral  power  possessed  here  must  characterize,  at  least  his  infancy,  in  the 
world  to  come.  "  In  the  place  where  the  tree  falleth  there  it  shall  lie." 
"  He  that  is  unjust  let  him  be  unjust  still  ;  he  that  is  holy,  let  him  be  holy 
still."  "  My  reward  is  with  me  to  give  to  every  man  according  as  his  work 
shall  be." 

Therefore  when  one  has  enumerated  to  himself  from  infancy  to  old  age 
the  fruit,  which  should  be  the  perpetual  outgrowth  of  his  nature  in  order  to 
obtain  the  eternal  meet  awarded  to  Christians,  and  finds  himself  failing, 
and  refailing,  m  his  efforts  to  produce  them,  it  discourages  and  demoralizes; 
and  in  many  persons  produces  their  descent  into  the  depths  of  immorality; 
others,  perhaps,  more  hopeful  and  persevering  in  their  natures,  press  on, 
but  suffer  material  demoralization,  by  a  recognition  of  the  result,  which 
may  come  of  the  knotty,  wormy,  imperfect  fruits,  which  are  the  issues  of 
their  life. 

Not  unfrequently  have  I  met  women  who  have  assured  me,  in  the  grief 
and  agony  of  their  souls,  that  they  would  be  good,  and  subdue  their  exci- 
table, passionate  dispositions,  if  they  could.  They  had  married  with  bright 
hopes,  and  the  determination  to  live  useful,  noble  lives;  had  been  obliged 
to  work  hard,  with  no  time  for  mental  cultivation;  their  husbands  had  gone 
on  from  one  degree  of  improvement  to  another,  until  they  were  no  company 
for  each  other;  which  is  always  heart-rending  to  a  sensible  woman;  child- 
ren had  come  fast  and  were  growing  up  disobedient  and  untrained;  they 
felt  responsible  for  it,  for  their  course  had  been  unsteady,  fretful  and  pas-» 
sionate;  they  had  tried  again  and  again  to  be  firm,  kind  and  judicious; 
but  ere  they  were  aware  of  it,  would  find  themselves,  in  a  fit  of  anger,  shorn 
of  their  strength.  And  so  they  had  come  to  the  conclusion  that  "  They 
could  not  be  good  and  there  was  no  use  of  trying." 

But  what  is  the  cause  of  all  this?  Effect  must  have  cause.  Two  items 
furnish  the  causes — one  the  primary,  the  other,  the  secondary.  First,  an 
unwholesome  training  in  youth — when,  if  that  sublime  injunction,  ''Know 
thyself"  had  been  obeyed,  by  a  study  of  the  mental,  moral,  and  physical 
laws  of  the  human  being,  — the  importance  of  obeying  them,  and  the 
strength  and  power  of  reason  acquired  for  self-control  -  accidents  and  casu- 
alties aside — the  secondary,  poor  health,  might  have  been  avoided,  and 
the  great  behest  of  life  nobly  and  sublimely  fulfilled. 

But  no — the  announcement  that  a  girl  baby  is  born  is  equivalent  to  cram- 
ming its  head  with  the  rules  of  etiquette,  coquetry,  and  a  fashionable  toi- 
lette, instead  of  anything  that  would  contribute  to  the  magnanimous  sym- 
metrical development  of  the  immortal  spirit.  The  instruction  is  early  given, 
that  the  one  who  plays  the  round  of  fashionable  life  the  most  successfully, 


SYMPTOMS  OF  DYSPEPSIA. 


105 


will  bear  off  the  palm  ofbeauty  and  grace,  indicative  of  woman's  highest 
capabilities  ;— hence  the  distorted  spine,  wasp  waist,  tiny  feet,  pale- 
faced,  sickly,  sentimental,  passionate,  powerless  woman  !  All  this  second- 
arily, the  outgrowth  of  false  dressing,  excesses  and  irregularities  in  eating, 
drinking,  sleeping,  and  slothful  inactivity. 

Probably  no  country  furnishes  such  multitudes  of  peevish,  fretful,  nervous 
women  as  the  United  States.  Who  can  wonder  that  one  is  all  worn  down 
with  nervous  debility,  and  only  keeps  herself  up  by  stimulants  ;  another 
afflicted  with  that  terrible  disease,  nervous  dyspepsia,  which  congests  the 
brain,  and  affects  the  mind  so  seriously  that  an  eminent  physician  has  com- 
pared persons  thus  diseased,  to  the  ancients  possessed  with  evil  spirits  ; 
another  with  engorgement  of  the  portal  vein  and  blood-vessels  of  the  liver, 
thus  interfering  with  its  depuratory  office,  and  not  only  clogging  up  the 
system,  but  mind  ;  another  with  consumption  ;  another,  diseases  peculiar 
to  her  sex,  which  have  the  most  direful  effect  upon  the  system  ;  and  still 
another  with  scrofula  in  some  form,  creating  not  only  a  feverish,  excitable 
condition  of  body,  but  mind,  making  its  position  unreliable.  Yes,  I  say, 
who  can  wonder  that  these  things  are  so,  if  they  consider  the  customs  and 
manner  of  life  of  women. 

Lacing  is  the  universal  practice,  and  it  sometimes  seems  that  all  are  aim- 
ing at  perfection  of  deformity,  if  possible.  Let  one  enforce  by  example  or 
word,  the  importance  of  a  dress  reform,  and  how  soon  will  all  unite  to  show 
their  dexterity,  in  pitching  the  sarcastic  quoits  of  ignorance  at  her  ;  as 
though  they  would  be  doing  God  service  if  they  could  cause  her  to  re- 
nounce common  sense  for  the  pursuit  of  disobedience  to  physical  laws,  and 
thereby  bring  on  the  long  catalogue  of  diseases  consequent  upon  the  pres- 
sure of  the  vital  organs — and  all  this  is  done  to  secure  false  beauty  and 
symmetry  of  form. 

Let  us  consider  the  difference  in  the  dressing  of  a  boy  and  girl.  Hi* 
clothing  reaches  from  head  to  foot,  and  hand,  equally  distributed  and 
loosely  made,  which  is  calculated  to  induce  good  circulation  and  develop- 
ment, from  two  reasons  : — first,  there  are  no  bands  or  corsets  to  form  liga 
tures  of  compression  and  irritation  about  his  body  ; — secondly,  equality  of 
clothing  secures  equality  of  warmth,  and  hence,  there  are  no  cold  extrem 
ities  deserted  of  the  blood,  which  must  congest  in  some  other  part  of  the 
body.  He  must  wear  flannel,  wadded  coats  and  vests,  with  thick-soled 
boots,  reaching  to  the  knees,  as  a  protection.  How  is  it  with  the  little 
girl  ?  Her  mother,  supposed  to  be  her  best  friend,  will  send  her  out  on  a 
cold  winter  day,  with  one -third  the  amount  of  clothing  she  does  her  boy. 
Thin  shoes  reaching  just  above  her  ankle,  with  one  thickness,  (a  cotton  or 
woollen  stocking,)  reaching  to  the  knee  ;  two  or  three  thin  layers  of  thin 
cloth  over  the  arms  ;  perhaps  a  little  more  about  the  waist  and  shoulders. 
But  it  would  not  do  to  burden  her  with  the  amount  of  clothing  the  boy 


io6 


DYSPEPSIA. 


wears,  or  rather,  it  would  prevent  the  exhibition  of  the  delicate  form,  which 
the  mother  had  contended  for  with  dame  Nature. 

But  is  this  all  ?  If  it  were,  we  might  hope  for  a  more  speedy  recovery  of 
woman's  health  ;  for  the  world  is  becoming  aroused  about  the  necessity  of 
a  dress  reform  which  is  destined  to  secure  improvements  at  least.  I 
believe  that  one  of  the  greatest  evils  of  woman's  life  is  intemperate  eating. 
Her  first  sin  was  committed  in  eating,  and  we  are  inclined  to  think  her  last 
will  be,  when  we  hear  Christian  women  talking  like  this  : — "  Do  you  suppose 
I  would  deny  myself  of  what  I  wanted  if  I  knew  it  would  make  me  sick?" 
Dear  sisters,  I  pray  you,  for  'tis  to  you  that  I  write,  not  to  close  your  ears 
to  the  fact,  that  our  God  is  a  God  of  justice,  and  that  He  would  not  have 
framed  and  established  laws  in  the  human  being,  without  attaching  a  pen. 
alty  to  their  disobedience  ;  and  that  in  nine  cases  out  of  ten,  sickness  is 
traceable  to  over-eating,  or  the  eating  of  such  combinations  as  would  de- 
stroy the  stomach  of  a  horse. 

Oh,  woman,  how  can  you  consciously  deprave  and  vitiate  the  powers 
which  God  designed  should  glorify  His  name,  by  the  influence  of  their 
fullest  capacity,  by  being  a  submissive  slave  to  the  lowest  passions  of  your 
nature  ?  That  this  is  done,  is  evident  to  casual  observers.  Women  not 
only  glut  and  gormandize  from  morning  till  night,  and  in  some  parts  of  the 
country,  eat  snuff,  and  drink  wine,  until  perversion  is  the  ruling  feature  of 
their  appetite,  but  they  transmit  the  disposition  to  their  children,  and 
compel  them  to  cultivate  it  ;  for  no  sooner  are  the  children  out  of  bed  than 
they  find  the  indispensable  "  piece"  in  their  hands,  a  faithful  friend  until 
bed  time  ;  and  not  unfrequently  does  it  accompany  them  thither.  And 
the  only  antidote  for  the  cries  of  a  suckling  babe,  is  its  " dinner,"  which  is 
seasonable  any  hour  in  the  twenty -four  ;  unless  it  cries  too  hard,  when  drugs, 
''soothing  syrup,"  "paregoric,"  etc.,  become  a  plus  quantity,  in  some 
cases  witli  a  piece  of  meat,  or  candy  to  suck  ;  for  it  wouldn't  do  to  deny 
it  anything  the  mother's  distorted  sympathy  supposes  it  would  like.  Not 
unfrequently  these  plus  quantities,  added  to  the  minus  quantity,  common 
sense  and  nature's  laws,  produce  a  quantity  minus  its  life.  Then  the 
lamentations  of  the  unhappy  parents  follow  ;  only  finding  consolation  m 
the  perverted  application  of  the  scripture—"  The  Lord  doeth  all  things 
well."  "He  giveth  and  He  taketh  away."  Instead  of  searching  out  the 
cause,  and  learning  wisdom  from  their  folly,  they  persistently  pursue  the 
same  course,  until  similar  results  are  again  produced. 

We  sometimes  think  that  no  woman  should  have  the  care  of  a  family, 
who  is  unversed  in  the  laws  of  being,  or  without  the  acquisition  of  self, 
control.  The  women  of  one  generation,  u.n governed  by  a  right  knowledge 
of  the  necessities  of  physical  and  spiritual  being,  and  the  avoidable  causes 
of  disease;  may  commit  sin  from  the  effects  of  which  three  generations  can- 
not recover. 


SYMPTOMS  OF  DYSPEPSIA. 


107 


The  prevalent  custom  on  the  part  of  most  women  of  wearing 
the  hair  twisted  into  a  mass  on  the  top  or  back  of  the  head, 
and  the  more  modern  and  still  more  pernicious  custom  of 
loading  the  head  with  false  hair,  or  substances  resembling  it, 
is  a  fruitful  source  of  headache,  and,  indirectly,  a  cause  of 
dyspepsia. 

Says  a  writer  in  the  Science  of  Health  :  "  And  not  hair  only, 
as  if  that  were  not  bad  enough,  but  hemp,  jute,  and  coarse  in- 
ferior vegetable  fibres,  must  be  raised  from  their  native  clod,  to 
intermingle  and  be  placed  on  a  par  with  that  most  unrivalled 
production  of  nature— the  crowning  glory  of  the  human  form. 
As  a  matter  of  health,  the  subject  assumes  a  more  serious 
aspect ;  much  more  so,  indeed,  than  many  of  our  ladies  have 
any  idea  of.  Perhaps  the  most  prevalent  complaint  among 
ladies  at  the  present  day  is  headache  ;  and  we  think  that  care- 
ful investigation  will  bear  us  out  in  asserting  that  this  trouble 
has  rather  increased  than  diminished  since  the  present  style  of 
wearing  the  hair  came  in  vogue,  involving,  as  it  does,  the 
loading  of  the  head  with  such  a  cruantity  of  foreign  material. " 

Ridiculous  and  silly  as  is  the  fashionable  head-toggery  of 
chignos,  frizzles,  pugs,  etc.,  the  ridiculousness  merges  into 
the  tragical  when  we  consider  the  inevitably  demoralizing 
effects  on  both  body  and  mind. 

THE  HORRORS. 

I  will  conclude  this  "  chapter  of  horrors  "  by  copying  one  of 
several  cases  which  I  have  published.  The  case  of  Mr.  Strong 
was  published  in  the  Philadelphia  Evening  Star  of  October  8, 
1872  : 

Written  for  "  The  Evening  Star." 

The  Horrors  Depicted.  — I  do  not  mean  remorse  of  con- 
science, nor  melancholy,  nor  "dumps,"  nor  "  blues,"  nor 
4  4  hypo, "  nor  what  the  phrenologist  would  term  ' '  hope  small ;" 
but  a  sense  of  unmitigated  wretchedness  disconnected  with  all 
considerations  of  conduct  or  character,  good,  bad  or  indifferent, 
and  unattended  with  any  outward  manifestations  of  disease. 

It  may  puzzle  the  reader  to  understand  how  a  person  can  be 


io8 


DYSPEPSIA. 


mentally  horrified  without  being  morally  bad  or  physically  sick. 
He  is  sick,  but  the  name  of  the  disease  is  not  found  in  the 
nosology,  nor  is  there  any  name  or  phrase  in  ancient  Latin  or 
modern  French  that  will  apply  to  it.     It  can  only  be  described. 

The  patient  is  in  agony  all  the  day,  and  afflicted  with  fright- 
ful visions  all  the  night.  He  is  utterly  miserable,  yet  cannot 
tell  why.  He  sees  nothing  but  sources  of  sorrow  in  this  life, 
and  imagines  nothing  but  suffering  in  the  next.  Everything 
around  him,  and  all  that  you  say  or  do,  aggravate  his  misery. 
He  sheds  no  tears,  his  face  is  blank  and  expressionless,  he  can- 
not laugh  nor  cry,  and  he  seems  to  know  nothing  and  care  for 
nothing  except  to  feel  bad. 

But  the  rationale  of  this  matter  is  very  simple.  It  means 
nothing  more  nor  less  than  a  torpid  liver  with  an  inactive  skin. 
The  bile  elements  are  retained  in  the  blood  because  of  tor- 
pidity of  that  great  excreting  gland,  the  liver;  they  are  not  ex- 
pelled through  the  skin  in  the  form  of  4 4  humors, "  because  of 
obstruction  of  that  emunctory.  The  consequences  are  the 
blood  becomes  thick,  viscid,  clogs  the  internal  viscera,  and  the 
whole  volume  of  circulating  fluid  is  pressed  from  the  circum- 
ference of  the  body  to  the  centre,  and  especially  upon  the  brain. 
Why  should  he  not  be  horrified  ? 

Put  your  finger  in  a  vise,  or  your  body  under  half  a  tons 
weight,  and  you  will  have  some  idea  of  the  pain  that  can  be 
produced  by  pressure.  The  felon  on  the  finger,  the  gout  of 
the  toes,  the  rheumatism  in  the  large  joints,  the  boil,  and  the 
carbuncle  are  intensely  painful  only  because  of  the  extreme 
pressure  consequent  on  accumulated  blood.  Let  the  blood  re- 
cede from  the  surface  and  accumulate  in  the  brain,  lungs,  liver, 
and  other  internal  organs,  and  there  will  not  be  acute  pain 
locally,  but  distress  generally.  Instead  of  smarting  or  throb- 
bing on  the  surface,  there  is  aching  and  agony  all  through.  The 
sense  of  misery  is  too  diffused  to  be  imputed  to  any  one  organ, 
hence  the  patient  cannot  tell  where,  how,  nor  why  he  is  dis- 
eased. 

All  persons  who  are  distinguished  as  having  a  "fine  flow  of 
animal  spirits,"  have  a  free  external  circulation;  the  vessels 


SYMPTOMS  OF  DYSPEPSIA. 


of  the  skin  are  well  filled  ;  and  so  long  as  this  condition  is 
maintained  the  "horrors"  can  never  be  experienced.  They 
may  be  sick,  afflicted,  or  unfortunate,  but  the  grief  and  depres- 
sion will  be  temporary.  It  is  impossible  for  such  persons  to  set- 
tle down  in  gloom  and  melancholy 

I  could  mention  the  name  of  several  persons  in  New  York 
and  Philadelphia,  who,  after  being  in  the  horrors  for  months, 
have  recovered  their  usual  good  health  and  spirits,  by  a  little 
hygienic  attention  to  the  functions  of  the  skin  and  liver.  I  am 
at  liberty  to  mention  one,  which  is  typical  of  all,  that  of  a  Mr. 
Strong,  produce  merchant  of  Philadelphia,  who  was  treated  at 
our  "  Hygeian  Home." 

The  horrors  in  Mr.  Strong's  case  were  horrible  in  the  ex- 
treme. He  would  pace  the  room  or  walk  the  hall  continually, 
sighing  and  groaning  as  though  some  terrible  calamity  was 
impending.  Nothing  that  could  be  said  would  comfort  him 
in  the  least.  He  seemed  perversely  determined  to  be  as  mis- 
erable as  possible,  and  make  others  so  to  the  extent  of  his 
ability  and  opportunity.  Yet,  poor  man,  he  could  not  help 
it.  The  whole  cause  of  all  his  trouble  was  within,  but  he 
fancied  it  was  everywhere  else.  His  imagination  was  just  as 
morbid  as  his  blood,  and  the  very  atmosphere  was  peopled 
with  Milton's  "devils  with  devils  damned,"  and  vengeful 
deities — the  reflections  of  his  own  mental  state. 

In  all  of  these  cases  we  have  only  to  purify  the  blood,  restore 
the  circulation  to  the  surface,  and  the  crushing  load  within  is 
removed,  the  fiends  and  demons  of  the  day  depart,  and  the 
ghosts  and  goblins  of  the  night  disappear.  As  soon  as  the 
patient  is  "all  right"  within  himself,  the  universe  becomes  all 
right  to  him. 

Mr.  Strong,  by  means  of  plain  simple  food,  tepid  bathings, 
and  active  manipulations  to  the  skin,  with  no  medicine  of 
any  kind,  soon  began  to  come  to  himself,  and  then  all  the 
world  came  to  him.  He  is  now  attending  to  business  as 
usual.  R.  T.  Trall,  M.D. 


I IO 


DYSPEPSIA. 


CHAPTER  XIII. 
DYSPEPSIA  AND  THE  CACHEXIES. 

That  nearly  all  those  forms  and  manifestations  of  morbid 
conditions  which,  in  medical  books,  are  termed  cachexia?,  or 
4 'depraved  habits  of  body,"  constituting  the  peculiar  diatheses 
called  tubercular,  scrofulous,  scorbutic,  hemorrhagic,  pletho- 
ric, dropsical,  consumptive,  and  even  entozoic,  or  verminous, 
are  primarily  caused  by  derangements  of  the  digestive  processes, 
is  becoming  more  and  more  the  opinion  of  pathologists. 

In  a  late  work  on  Pulmonary  Consumption,  by  C.  J.  B. 
Williams,  M.  D.,  F.  R.S.,  of  London,  who  is  regarded  as  the 
first  pathologist  in  Great  Britain,  if  not  in  Europe,  the  author 
substantially  affirms  the  doctrine  I  have  all  along  advocated. 
Dr.  Williams  is  at  the  head  of  an  extensive  hospital  and  school 
in  London  ;  has  had  an  experience  of  forty  years,  and  his  ob- 
servations are  based  on  a  careful  study  of  the  data  of  one 
thousand  selected  cases  recorded  in  his  note-book.  The  im- 
portance to  be  attached  to  Dr.  Williams'  conclusions  may  be 
inferred  from  the  following  notice  of  his  work  by  the  New  York 
Medical  Review  for  January,  1873  : 

"The  author  of  this  work  needs  no  introduction  to  the  medical  world, 
as  his  *  Principles  of  Medicine  '  is  a  standard  work  in  both  Europe  and 
America.  As  the  student  of  Alison,  Laennec,  Andral,  and  Chomel,  he 
learned  what  those  distinguished  authors  had  to  teach,  both  at  the  bedside 
and  at  the  dead-house.  The  knowledge  thus  acquired  was,  for  the  subse- 
quent twenty  years,  constantly  applied  at  St.  George's  and  University 
I  lospitals,  where  he  attended  the  wards  almost  daily,  and  always  superin- 
tended personally  the  post-mortems.  In  addition  to  this,  Dr.  Williams' 
experience  in  diseases  of  the  chest  in  private  practice  for  the  last  forty 
years,  has  not  been  exceeded  by  that  of  any  other  physician. 

"With  these  facts  before  us,  and  the  recognized  ability  of  the  author, 
we  are  warranted  in  expecting  an  exhaustive  and  reliable  resume  of  the 
subject  under  consideration. 

"The  author's  theory  of  the  pathology  of  this  disease  is  based  on  his 
own  observations,  aided  by  the  recent  researches  of  Lionel  Beale,  Reck- 
linghausen, Strieker,  Cohnheim,  Max  Scheultzer,  and  others,  in  regard  to 


DYSPEPSIA  AND  THE  CACHEXIES. 


Ill 


the  processes  of  the  living  plasma  or  formative  material  from  which  tex- 
tures are  produced." 

Dr.  Williams  indicates  his  theory  of  the  pathology  of  con- 
sumption in  the  following  words  : 

'  "  It  is  not  possible  to  convey  in  a  few  words  the  views  on  the  nature  of 
Phthisis,  to  which  I  have  been  led  by  observation  and  reflection  on  the  facts 
and  opinions  of  others  as  well  as  my  own  :  but  the  popular  terms  decline 
and  consumption  are  the  most  significant  which  I  can  employ  to  represent 
them.  I  believe  Pulmonary  Consumption  to  arise  from  a  decline  or  defi- 
ciency of  vitality  in  the  natural  bioplasm  or  germinal  matter,  and  this 
deficiency  manifests  its  effects  not  only  in  a  general  wasting  or  atiophy  of 
the  whole  body,  but  also  in  a  peculiar  degradation,  chiefly  in  the  lungs  and 
lymphathic  system,  of  portions  of  this  bioplasm  into  a  sluggish  low  lived,  yet 
proliferating  matter,  which,  instead  of  maintaining  the  nutrition  and  integ- 
rity of  the  tissues  (which  is  the  natural  office  of  the  bioplasm),  clogs 
them  and  irritates  them  with  a  substance  which  is  more  or  less  prone  to 
decay,  and  eventually  involves  them  also  in  its  own  disintegration  and  de- 
struction. This  degraded  bioplasm,  which  I  will  call  phthi nop/asm  (wast- 
ing or  decaying  forming  material),  may  be  thrown  out  locally,  as  a  result 
of  inflammation  ;  or  it  may  arise  more  spontaneously  in  divers  points  of  the 
bioplasm  in  its  ordinary  receptacles,  the  lymphatic  glandular  system  ;  and 
then  it  commonly  appears  in  the  form  of  miliary  tubercles,  scattered  through 
the  adenoid  tissue  of  the  lungs. 

*'  I  would  characterize  all  consumptive  diseases  heretofore  classed  under 
the  terms  Tuberculous  and  Scrofulous,  together  with  the  products  of  low 
and  chronic  inflammation,  as  instances  of  a  lowered  vitatity  of  the  bioplasm; 
and  I  would  strongly  insist  on  their  being  totally  distinct,  on  the  one  hand, 
from  cancer  and  other  malignant  diseases,  the  characteristic  of  which  is  a 
new  kind  of  vitality,  a  new  growth,  perhaps  parasitic,  with  new  organic 
elements,  foreign  to  those  of  the  tissues  which  they  invade  and  destroy  ; 
and  on  the  other  hand,  distinct  also  from  total  loss  of  vitality,  death  of  the 
bioplasm,  which  would  speedily  result  in  decomposition,  gangrene,  and 
putrefaction  ;  to  such  a  result  phtlnnoplasms  do  occasionally  lead,  but  it  is 
not  a  part  of  their  common  history.  That  this  latter  distinction  is  not 
sufficiently  observed  by  some  German  writers  is  evident  from  their  applying 
the  term  necrobiosis  to  caseation,  which,  although  a  process  of  decay  from 
lowered  vitality,  does  not  indicate  the  absolute  death  of  every  living  part, 
as  in  a  slough  or  gangrene.  It  will  be  seen  in  the  chapter  on  Fatty  De- 
generation (which  thirty  years  ago  was  a  special  object  of  my  study),  that  I 
have  traced  a  resemblance  to  vegetable  life  in  its  process  and  products  ; 
and,  although  ultimately  destructive,  it  is  the  most  gentle  step  towards  the 
death  of  the  tissues.    Nay,  various  proofs  will  be  adduced  that  fatty  trans- 


112 


DYSPEPSIA. 


formation  is  often  a  salutary  process,  assisting  materially  in  the  removal  of 
phthinoplasm  and  other  superfluous  products  of  inflammation. " 

"The  great  indication  lu  sustain  the  vitality  and  sufficiency  of  the  bio- 
plasm,  by  all  available  means,  medicinal,  regiminal,  and  climatic,  will  be 
the  first  suggestion  for  the  prevention  and  treatment  of  consumptive  dis- 
eases. A  second,  equally  obvious,  will  be  the  avoidance  of  all  influences 
which  may  injure  the  bioplasm  ;  generally,  by  deleterious  action  on  the 
whole  body  ;  or  locally,  by  exciting  low  inflammation  in  the  lungs  or  other 
organs.  A  third  indication,  more  difficult  than  the  others  in  its  fulfilment, 
is  to  counteract  the  injurious  effects  of  phthinoplasms  alread"  formed,  and 
to  promote  their  quiescence  or  removal." 

DYSPEPSIA    AND  WORMS. 

All  of  the  varieties  of  entozoa  which  infest  the  alimentary 
canal,  would  have  no  existence  there,  were  it  not  for  the  pro- 
ducts of  indigestion  on  which  they  feed.  Because  they  are 
scavengers,  some  physicians,  who  were  poor  physiologists,  have 
regarded  them  as  wholesome  and  necessary  to  consume  the 
offal,  etc.  But,  in  a  healthy  state  of  the  digestive  organs,  there 
would  be  no  offal  for  them  to  scavengerize.  The  effete  matters 
(excretions)  would  be  expelled  as  often  as  necessary,  and  not 
allowed  to  accumulate  so  as  to  afford  shelter  and  sustenance 
for  these  troublesome  pests. 

Children  whose  dietary  consists  largely  of  greasy  foods, 
sugar,  and  fine  flour,  always  have  constipated  bowels,  and 
are  always  affected  with  worms.  The  immediate  cause  of  all 
such  vermin  as  effect  a  permanent  lodgment  in  the  alimentary 
canal  is  alimentary  uncleanliness.  And  uncleanliness  in  our 
dwellings  and  surroundings  is  the  sole  cause  of  all  the  noxious 
insects  or  animalculae  which  annoy  us  and  destroy  our  fruits  and 
vegetables,  as  well  as  the  cause  of  all  contagious  diseases — 
small-pox,  measles,  scarlatina,  wrhooping-cough,  mumps, 
influenza,  etc.,  of  human  beings,  and  glanders,  murrain,  rin- 
derpert,  epizooty,  gapes,  staggers,  etc.,  of  domestic  animals. 

The  "measly  "  livers  of  stall-fattened  and  sty-fattened  cattle 
and  hogs,  is  nothing  more  nor  less  than  an  insect,  not  unlike 
the  louse  or  crab,  which  burrows  in  the  substance  of  the  liver, 
or  lodges  in  some  portion  of  the  intestinal  tube.  Its  form  and 
shape  conform  to  the  locality  in  which  it  develops  and  propa- 


DYSPEPSIA  AND  THE  CACHEXIES. 


"3 


gates  its  kind.  In  the  bowels  it  elongates  into  the  tape-worm. 
It  often  makes  its  way  into  Other  glands,  and  into  the  areolar 
and  muscular  tissues  of  animals,  especially  of  the  hog  ;  and  is 
so  tenacious  of  life  that  ordinary  boiling  does  not  destroy  it. 
In  the  Crimea,  during  the  late  Turko-Russian  war,  the  British 
soldiers  became  so  frequently  affected  with  tape-worms  that 
they  finally  traced  it  to  pork  rations,  and  refused  to  partake  of 
them. 

Raw  sugars  are  another  common  source  of  "  measles"  in 
the  glands  and  bowels.  The  sugar  insect  (which  is  the  cause 
of  that  tormenting  skin  affection  known  as  "  grocer's  itch),  is 
found  in  nearly  all  of  the  brown  sugars  of  commerce.  More 
than  one  hundred  thousand  have  been  found  in  a  single  pound 
of  "merchantable  '  Muscovado  sugar. 

A  late  writer  in  an  agricultural  journal  published  at  Memphis, 
Tenn.,  ("Philips'  Southern  Farmer,")  attributes  worms  in 
colts  to  indigestion.  He  says  :  "  It  is  the  opinion  of  many 
veterinarians  that  worms  in  colts  are  usually  connected  with 
indigestion  ;  that  is,  they  produce  ill-health  when  the  digestive 
organs  are  disordered.''  They  produce  ill-health  whenever 
present.  Indigestion  causes  their  presence,  and  then  their 
presence  aggravates  the  indigestion. 

A  writer  in  a  late  number  of  the  London  Field  states  that  the 
gape  worm  among  chickens  is  unusually  prevalent.  If  he  will 
examine  into  the  sanitary  conditions  around  those  wormy 
chickens,  he  will  find  uncleanliness  correspondingly  prevalent. 

We  have  the  authority  of  Scripture  that  all  "evil  beasts  shall 
cease  out  of  the  land"  when  the  people  obey  "the  ways  of  the 
Lord,"  which  means,  I  suppose,  when  they  keep  themselves 
and  their  surroundings  clean,  and  till  the  earth  on  hygienic 
principles. 


114 


DYSPEPSIA. 


CHAPTER  XIV. 
PRINCIPLES  OE  TREATMENT. 

There  are  two  methods  of  treating  dyspeptics  ;  one  aims  to 
cure  the  disease ;  the  other  endeavors  to  cure  the  patient. 
All  drug  medical  systems  profess  to  cure  diseases  ;  and  they 
can  do  it,  whatever  becomes  of  the  patient.  The  Hygienic 
medical  system  is  based  on  the  fundamental  premise  that 
disease  should  vol  be  cured  ;  but  that  its  causes  should  be  remov- 
ed, to  the  end  that  the  patient  may  recover  health.  All  drug 
systems  teach  that  disease  is  an  entity  or  substance  ;  a  some- 
thing  at  war  with  vitality  which  should  be  suppressed,  opposed, 
counteracted,  subdued,  expelled,  killed,  or  cured  ;  hence  it  is 
opposed  with  all  of  the  missiles  of  the  drug  shop.  The  Hygi- 
enic system  teaches  that  disease  is  a  remedial  effort — a  struggle 
of  the  vital  powers  to  purify  the  system  and  recover  the  normal 
state.  This  effort  should  be  aided,  directed  and  regulated,  if 
need  be,  but  never  suppressed.  And  this  can  always  be  better 
accomplished  without  medicines  than  with  them. 

Few  persons  are  aware  how  many  of  their  ailments,  of  which 
they  suffer  for  years,  if  not  for  life,  are  attributable  to  the  med- 
icines which  so  promptly  relieved  them  of  some  trivial  pain  or 
slight  indisposition.  Many  of  the  infirmities  and  diseases  of 
youth  and  manhood  can  be  traced  to  the  remedies  which  cured 
their  ailments  of  infancy  and  childhood. 

Professor  E.  R.  Peaslee,  M.  D.,  of  New  York,  said  to  his 
medical  class  a  few  years  ago:  "The  administration  of 
powerful  medicines  is  the  most  fruitful  cause  of  derangements 
of  the  digestion." 

Professor  Alonzo  Clark,  M.  D.,  of  the  New  York  College 
of  Physicians  and  Surgeons,  said,  in  a  lecture  to  the  medical 
class,  not  long  since  :  "All  of  our  curative  agents  are  poisons, 
and,  as  a  consequence,  every  dose  diminishes  the  vitality  of  the 
patient. " 


PRINCIPLES  OF  TREATMENT. 


And  Professor  John  C.  Draper,  M.  D. ,  says:  " Vitality 
once  lost  can  never  be  regained." 

Authorities  agai?isi  drug  remedies  could  be  quoted  from  the 
highest  authorities  of  the  medical  profession  to  any  extent. 
But  I  will  conclude  with  as  many,  from  the  same  source,  in 
favor  of  Hygienic  medication. 

"  The  same  uncertainty  exists  in  medicine  that  the  law  is  so  justly  noted 
for.  We  do  not  know  whether  our  patients  recover  because  we  give  medi- 
cine, or  because  nature  cures  them.  Perhaps  bread  pills  would  cure  as 
many  as  medicine."  Prof.  J.  VV.  Carson,  M.D. 

"  The  older  physicians  grow  the  more  skeptical  they  become  of  the  vir 
tues  of  medicine,  and  the  more  they  are  disposed  to  trust  to  the  powers  of 
nature."  Prof.  Alex.  H.  Stevens,  M.D. 

" 1  wish  the  Materia  Medica  was  in  Guinea,  and  that  you  would  study 
Materia  Aliuieniaria.  You  are  taught  learnedly  about  Materia  Medica, 
and  but  little  about  diet.  We  will  have  less  of  doctors  when  people  eat  to 
live.  Prof.  Willard  Parker,  M.D. 

The  rational  treatment  of  dyspepsia,  in  all  its  states,  stages, 
forms  and  complications,  consists  in  supplying  the  condition 
of  health.  This  is  the  way  to  "aid  and  assist  nature"  prop- 
erly and  effectually.  Instead  of  "curing  one  disease  by  pro- 
ducing another,"  we  should  aim  to  cure  the  patient  in  such  a 
manner  as  to  leave  him  sound  and  whole. 


CHAPTER  XV. 
POOD. 

A  correct  dietary  should  be  placed  at  the  head  of  all  of  our 
therapeutic  measures  ;  for  without  this  all  other  appliances  may 
fail,  and  certainly  will  fail  to  afford  more  than  temporary  ben- 
efit. And  all  food  should  be  plain,  simple,  of  a  consistence 
to  insure  proper  mastication,  and  of  but  few  articles  at  a  single 
meal.  With  these  general  rules  kept  in  view,  a  good  Hygienic 
cook  can  furnish  as  great  a  variety  of  dishes  as  any  who  "  eats 
to  live  "  can  desire. 

Bread  is  of  the  first  importance.    But,  unfortunately,  there 


ii6 


DYSPEPSIA. 


is  no  wholesome  bread  in  the  market.  The  public  taste  and 
judgment  are  so  perverted  that  a  good  article  could  find  no 
purchasers  at  the  provision  stores,  and  those  who  would  have  it 
must  make  it,  or  cause  it  to  be  made. 

Fine  flour  and  yeast  are  things  to  be  eschewed.  Wholesome 
bread  can  contain  only  two  ingredients — unbolted  meal  and 
water.  Atmospheric  air  is  the  only  "  rising  "  that  is  needed  or 
that  should  be  tolerated.  Yeast  fermentation  is  a  rotting  process, 
and  acids  and  alkalies  are  pernicious  because  of  the  saline  mat- 
ters which  result  from  their  combination.  Wheat-meal  is  more 
generally  preferred.  The  following  recipe  will  make  perfect 
bread,  if  properly  manipulated. 

"Mix  unbolted  wheat  meal  (freshly  ground)  with  pure  cold  water,  to 
make  a  stiff  dough  ;  knead  the  dough  thoroughly,  working  in  as  much 
meal  as  possible  ;  cut  into  small  pieces  and  bake  in  a  quick  oven.  It  wi! 
bake  quicker  and  keep  longer  if  made  into  rolls  a  little  larger  than  the 
finger  ;  or  into  cakes  one  half  or  three  fourths  of  an  inch  in  thickness,  t\v«» 
inches  wide,  and  three  inches  long.  This  bread  may  be  dried  as  hard  as  a 
brick,  and  kept  sweet  and  good  for  weeks.  You  have  only  to  dip  it  ni 
water  a  minute,  and  let  it  stand  five  minutes,  to  have  as  tender,  wholesome 
and  delicious  bread  as  need  be  eaten." 

Hot  water,  instead  of  cold,  is  preferred  by  some  ;  and  on  my 
"  Hygeian  Home  "  table  we  have  both  kinds.  This  has  a 
somewhat  firmer  crust,  a  softer  body  and  sweeter  taste,  but  will 
not  keep  so  long  as  that  made  with  cold  water. 

An  expert  bread-maker  can  also  make  very  light  loaf  bread 
with  either  cold  or  hot  water  and  meal.  I  have,  at  this  writ- 
ing, bread  within  reach,  made  one  year  ago,  which  is  both 
sweet,  delicious,  and  wholesome.  It  was  made  in  small  rolls, 
about  as  large  and  long  as  my  middle  finger,  then  dried  in  the 
sun,  or  before  a  stove.  I  do  not  know  why  it  would  not  re- 
main unchanged,  if  kept  dry,  for  a  thousand  years.  This  is 
the  best  possible  manner  of  preparing  bread  for  long  journeys, 
or  for  economy  of  room  and  expense.  One  pound  of  it  has 
more  real  nutriment  than  a  ton  of  that  spurious  stimulant 
known  as  "  Liebig's  Extract  of  Meat/'  I  have  carried  it  to 
England,  kept  it  four  weeks  in  that  humid  climate,  and  found 
it  good  and  sweet  after  returning. 


FOOD. 


117 


Some  years  ago  I  offered  a  premium  of  one  hundred  dollars 
for  the  best  bread.  More  than  one  hundred  specimens  were 
in  competition,  and  a  committee,  chosen  for  the  purpose,  made 
the  award  to  the  following  : 

"  Mix  unbolted  meal  of  any  grain  preferred,  or  of  a  mixture  of  two  or 
more  kinds  in  any  proportions  which  may  be  preferred,  with  pure  water, 
either  cold  or  hot.  If  cold  water  is  employed,  the  meal  and  water  should 
be  mixed  to  the  consistency  of  thick  batter  ;  then  beaten  or  stirred  a  little 
with  a  spoon  or  ladle  to  incorporate  more  atmospheric  air  ;  after  which* 
more  meal  is  to  be  added,  until  the  mass  becomes  as  stiff  a  dough  as  can 
well  be  kneaded.  Knead  the  dough  a  few  minutes  (and  the  more  the  dough 
is  kneaded,  the  more  brittle  and  tender  the  bread  will  be),  cut  into  pieces 
or  cakes  half  an  inch  or  three-quarters  of  an  inch  in  thickness,  and  about 
two  inches  in  diameter,  and  bake  in  a  quick  oven — as  hot  as  possible  with- 
out burning  the  crust,  which  must  be  carefully  guarded  against.  It  is 
better  to  moderate  the  heat  of  the  oven  a  little  after  three  or  five  minutes. 

If  hot  water  is  used,  it  should  be  boiling  hot,  and  the  meal  and  water 
stirred  together  very  quickly  with  a  strong  spoon  to  the  consistency  ot 
dough,  not  quite  so  stiff  as  that  for  ordinary  loaf  bread  made  of  fine  flour. 
It  is  then  to  be  cut  into  pieces  or  cakes,  and  baked  as  above.  Either  form 
of  bread  may  be  made  mto  larger  or  smaller  cakes,  or  into  loaves  of  any 
convenient  size  to  bake,  and  baked  in  a  gas,  wood,  coal,  or  kerosene  stove, 
or  in  an  oven  ;  and  the  crust  be  rendered  as  soft  and  tender  as  may  be 
desired,  by  enveloping  the  cakes  or  loaves  a  short  time  in  wet  cloths 
immediately  on  being  taken  from  the  oven.  The  small  cakes,  when  made 
with  hot  water,  will  soon  become  as  tender  as  even  the  toothless  can  desire, 
by  being  kept  in  a  covered  earthen  crock  ;  or  they  may  be  rendered  as 
hard  and  solid  as  the  soundest  teeth  can  require,  by  leaving  them  un- 
covered and  in  a  dry  place." 

Excellent  and  wholesome  fruit-cake  can  be  made  by  the 
addition  of  dates,  raisins,  figs,  or  other  sweet  fruits. 

I  protest  against  an  article  of  bread,  called  ' ■ gems," 
which  are  made  in  some  families,  and  are  constantly  on  the 
table  of  some  pretended  "Water-cures"  or  "Hygienic  Insti- 
tutes." The  pans  in  which  they  are  cooked  are  greased,  so 
that  the  sham  is  fried  rather  than  baked  ;  the  crust  is  usually 
very  hard  or  burned,  and  the  inside  soft  and  mushy.  Such 
stuff  is  eminently  dyspepsia-producing. 

Rye  meal,  corn  meal,  rye-and-corn,  and  oatmeal  bread  or 
cake  may  be  made  in  the  same  manner  as  that  of  wheat-meal. 


n8 


DYSPEPSIA. 


Wholesome  pastry  can  be  made  of  meal  and  fruits  of  any 
kind  ;  if  the  fruits  are  too  acid  to  suit  the  taste,  they  can  be 
modified  with  more  or  less  fruit  of  a  sweeter  kind,  as  dates, 
raisins,  figs,  etc.  By  placing  a  damp  cloth  over  the  crust  for 
a  short  time  after  it  is  taken  from  the  oven  the  crust  will  be  as 
tender  as  the  feeblest  teeth  require.  A  dry  cloth  will  render  it 
as  tender  as  most  persons  care  for. 

Wheaten  grits,  hominy,  samp,  oatmeal,  mush,  boiled  rice, 
etc.,  may  be  used  occasionally  as  a  part  of  the  meal ;  but  hard 
bread,  a  green  apple,  or  something  similar,  should  always  be 
eaten  with  them  to  insure  mastication. 

Soups  and  gruels  are  permissible  also  occasionally,  with  the 
same  conditions.  Of  the  soups  for  dyspeptics  none  is  better 
nor  more  generally  relished  than  the  potato.  Beans,  split-peas, 
rice,  tomato,  and  barley,  are  among  the  admissible  articles  for 
soups. 

Of  the  fruits  and  vegetables  in  our  markets,  but  few  are  ob- 
jectionable ;  but  only  one  or  two  kinds  should  be  taken  at  one 
meal.  Those  who  are  troubled  with  flatulence,  colic,  spitting 
up  the  food,  or  nausea  after  meals,  should  not  take  fruit  and 
vegetables  at  the  same  meal.  For  such  persons  bread  and 
fruit,  and  perhaps  mush,  for  breakfast,  and  bread  and  vegeta- 
bles for  dinner,  is  the  better  plan. 

Very  sour  fruits  and  acid  vegetables,  as  cranberries,  lemons, 
onions,  radishes,  celery,  &c,  had  better  be  dispensed  with. 
There  are  plenty  of  better  things. 

Of  animal  foods  little  need  be  said.  I  prefer  an  exclusively 
vegetarian  diet  when  it  can  be  properly  prepared.  But  with 
many  persons  animal  food  is  a  necessity  in  the  sense  of  being 
the  lesser  evil.  At  an  ordinary  hotel  or  boarding-house  the 
bread-food  is  all  of  the  commercial  kind,  and  lean  flesh-meat 
is  the  better  article.  But  pork,  shell-fish,  fat,  and  all  fried 
dishes  should  be  abstained  from.  Lean  beef  and  mutton  are 
the  best,  or  least  objectionable  kinds  of  flesh-meat. 

Eggs  are  not  so  good  as  the  better  kinds  of  flesh-meat,  nor 
so  bad  as  many  other  kinds.    Flesh  food  should  never  be 


FOOD. 


II9 


cooked  in  any  other  manner  that  broiling  or  boiling ;  and  eggs 
should  always  be  soft-boiled. 

Condiments  and  seasonings  of  all  kinds  can  be  disposed  of 
in  few  words — the  less  the  better.  Those  who  are  accustomed  to 
high-seasonings  will  recover  a  more  normal  taste  and  soon  learn 
to  relish  very  plain  cooking,  by  gradually  reducing  the  quan- 
tity. I  have  known  many  persons  learn  to  like  all  dishes  bet- 
ter without  sugar  than  with  it  in  a  few  weeks,  after  having  used 
it  excessively  for  years.  And  I  could  make  the  same  remark 
with  regard  to  vinegar,  salt  and  butter.  None  of  these  things 
are  foods,  in  the  proper  sense  of  the  word,  the  medical  pro- 
fession to  the  contrary  notwithstanding. 

Another  important  advantage  of  diminishing  the  thirst-pro- 
voking seasonings  is,  little  or  no  desire  for  drink  at  meals. 

Much  experience  and  observation  have  convinced  me  that 
the  excessive  use  of  sugar  in  this  country  is  a  prolific  source  of 
indigestion,  constipation,  * '  biliousness  "  and  erysipelatous  erup- 
tions. For  fifteen  years  I  allowed  a  part  of  my  patients  to  use 
sugar  moderately.  For  ten  years  past  I  have  had  no  sugar  on 
their  table  ;  and  the  results  of  the  change  are,  I  hear  but  little 
of  the  heartburn,  acidity,  fetid  breath,  and  "stomatitis"  of 
which  my  patients  formerly  complained  so  much. 

At  a  meeting  of  the  Polytechnic  branch  of  the  American 
Institute,  at  Cooper  Union,  New  York,  Professor  J.  V.  C. 
Smith,  M.D.,  in  a  lecture  on  milk,  stated  that  the  liver  was  a 
sugar-making  organ  ;  and  he  argued  that,  because  the  liver 
performed  a  4 'glycogenic"  function,  children  should  be  allow- 
ed to  eat  sugar  freely — also  adults.  I  do  not  see  how  the  con- 
clusion is  legitimate  from  the  premises.  If  it  is  the  business 
of  the  liver  to  make  sugar,  let  the  liver  do  it.  The  liver  makes 
bile.  Would  Professor  Smith  recommend  us  to  take  bile  as 
food? 


V 


1 20  DYSPEPSIA. 


CHAPTER  XVI. 
DRINK. 

Water-drinking  between  meals  should  be  according  to  thirst. 
It  is  a  mistake  to  load  a  weak  stomach  with  cold  water  on  the 
theory  that  it  is  a  tonic.  Food  and  drink  have,  fortunately, 
no  medicinal  properties,  and  should  never  be  taken  for  any 
purpose  but  to  supply  necessary  material  for  use.  As  a  habit 
it  is  well  to  take  a  tumbler,  or  part  of  one,  of  pure  soft  water, 
after  dressing  in  the  morning,  and  let  the  drink  be  regulated 
by  the  thirst  at  all  other  times.  As  I  have  explained  in  the 
preceding  part  of  this  work,  it  is  not  compatible  with  perfect 
digestion  to  drink  at  all  at  meals.  Those  who  use  seasonings, 
and  those  who  are  thirsty  while  eating,  should  take  as  little  as 
may  be  consistent  with  comfort.  Small  sips  will  often  allay 
thirst  as  well  as  larger  draughts  and  be  much  better  for  the 
stomach.  Very  cold  water  is  certainly  unhygienic  at  meals, 
and  especially  bad  for  dyspeptics.  Some  medical  authors,  and 
among  them  Dr.  G.  B.  Wood  ("  Wood's  Practice  of  Medicine") 
recommend  ice-cream  after  meals  as  a  tonic.  Few  things  could 
be  worse.  Hot  coffee  or  tea  would  be  the  lesser  evil.  I  have 
known  many  patients  who  were  subject  to  inflammation  and 
hemorrhage,  suffer  severely  and  invariably  of  bleeding  piles 
soon  after  eating  ice-cream,  nor  do  I  regard  the  iced- water,  or 
bits  of  ice  which  are  so  generally  administered  to  cholera  pa- 
tients, as  either  proper  or  beneficial.  The  reason  that  they 
must  be  pernicious  is  sufficiently  obvious  to  one  who  sees  "the 
pathology  of  the  disease"  through  unprejudiced  spectacles. 
The  cold  water  or  ice  in  the  stomach  determines  the  blood  from 
the  surface  of  the  body  to  the  central  organs,  aggravating  the 
internal  congestion,  which  is  the  chief  point  and  only  danger 
in  the  case.  So  with  dyspeptics  whose  internal  viscera  are  al- 
ways in  a  greater  or  less  degree  of  congestion,  ice-cream  or 
large  draughts  of  cold  water,  not  only  interfere  with  the  process 
of  digestion,  but  determine  the  blood  from  the  surface,  where 


DRINK. 


121 


it  is  already  deficient,  to  the  central  organs  where  it  is  already 
in  excess. 

The  dyspeptic  should  avoid  hard  water  as  he  would  hard 
drugs,  for  all  the  hard  waters  on  the  earth  are  only  drugs  in 
solution.  All  of  the  mineral  and  medicinal  springs,  from 
Saratoga  to  White  Sulphur,  and  from  Cheltenham  to  Vichy, 
are  only  modifications  of  the  oceans,  the  great  reservoirs  of  all 
the  impurities  that  water  can  dissolve.  No  one  thinks  of  drink- 
ing them  when  well,  nor  would  any  one  be  content  to  have  his 
food  cooked  in  them,  But  when  sick,  presto,  the  more  earthy, 
saline,  alkaline,  and  mineral  ingredients  they  contain,  the 
more  they  are  in  demand  !    Such  is  fashion. 

I  have  long  been  convinced  that  a  better  method  for  convert- 
ing grain  into  meal  or  flour  ;han  by  grinding  between  stones, 
was  among  the  desiderata  of  a  hygienic  mode  of  life.  The 
ordinary  process  of  grinding  inevitably  impregnates  the  meal  or 
flour  with  more  or  less  pulverized  stone.  The  quantity  may 
be  infinitesimally  small  in  a  single  loaf  of  bread,  nevertheless 
some  chance  particle  not  reduced  to  impalpable  powder  may 
be  transferred  to  the  body  of  the  one  who  partakes  of  the  loaf, 
lodge  in  the  joints,  liver,  kidney,  or  bladder,  and  become  the 
nucleus  of  concretions  which  occasion  painful  ox  fatal  diseases. 

The  hygienic  method  of  preparing  meal  (and  flour  should 
not  be  prepared  at  all)  is  by  cutting  or  pounding,  as  was  done 
before  flouring  mills  were  invented.  And  the  following  para- 
graph, which  I  copy  from  an  exchange  paper,  indicates  that  the 
right  idea  has  already  become  embodied  in  machinery  : 

"  Flour  Without  Millstones. — A  machine  for  making  flour  without 
the  use  of  millstones,  has  just  been  started  in  England.  The  grain  is  crushed 
by  one  thousand  little  trip  hammers  attached  to  the  proper  machinery  to 
produce  the  results  desired.  The  new  machinery  is  very  cheap  and  does  up 
its  work  in  a  scientific  manner.  The  flour  produced  is  said  to  be  far  su- 
perior to  that  obtained  by  grinding.  A  pounding  mill  costing  $1,000  will 
produce  as  much  flour  every  day  as  an  old  fashioned  mill,  costing  $5,000. 
The  new  mill  is  very  simple.  When  a  hammer  is  out  of  order  you  'can  re- 
place the  same  for  a  few  cents.  For  four  thousand  years  millers  have  pro- 
duced  flour  by  grinding  the  grain  with  stones.  The  new  idea  gives  a  new 
departure.  What  results  it  will  produce  1.  'his  country  remain  to  be  seen." 


i22 


DYSPEPSIA. 


In  those  complications  of  indigestion  indicated  by  torpid 
liver,  gall-stones,  intestinal  concretions,  albuminaria,  or 
'  Wright's  disease  of  the  kidneys/'  mineral  and  hard  waters  of 
all  kinds  are  extremely  pernicious.  An  1  they  are  scarcely  less 
so  in  rheumatic  and  gouty  affections,  gravel,  catarrh  of  the 
bladder  or  uterus,  and  duodenitis. 

There  is  no  beverage  in  the  universe  except  water,  and  there 
is  but  one  rule  for  its  quality — the  purer  the  better.  Those  who 
reside  where  all  the  water  of  the  streams,  springs,  and  wells  is 
hard,  have  only  the  alternatives  of  getting  their  supply  of  fluids 
from  juices,  fruits  and  vegetables,  catch  rain  water,  obtain  pure 
water  by  distillation,  or  be  sick.  Few  persons  imagine  the 
' '  wear  and  tear  "  that  is  constantly  disorganizing  their  structures, 
and  bringing  them  prematurely  to  the  grave,  in  consequence  of 
drinking  hard  water.  The  foreign  particles  are  everywhere 
occasioning  a  wasteful  friction  of  the  vital  machinery,  deranging 
the  blood-corpuscles,  damaging  the  secretions,  and  destroying 
the  molecules  of  the  tissues.  If  the  railroad  companies  of  the 
world,  instead  of  keeping  all  the  machinery  of  the  locomotives 
and  rolling  stock  well  oiled,  so  as  to  obviate  friction  to  the 
greatest  possible  extent,  should  apply  sea-water,  or  Congress 
water,  or  the  hard  water  of  lime-stone  regions,  to  the  machinery, 
not  one  of  the  roads  could  pay  running  expenses ;  the  iron 
would  rust,  the  wood  work  be  strained,  the  joints  would  break, 
and  all  would  go  to  ruin  speedily.  The  principle  that  machi- 
nery will  work  long  and  well  in  inverse  ratio  to  the  friction,  is 
as  applicable  to  vital  as  it  is  to  mechanical  organisms. 

CHAPTER  XVII. 
EXERCISE. 

Next  in  importance  to  a  proper  dietetical  regimen,  if  not 
equally  important,  is  systematic  exercise.  Those  dyspeptics 
who  are  so  fortunate  as  to  have  some  healthful  vocation,  may 
need  no  special  instruction  on  this  subject,  except  in  relation 
to  special  exercises  for  special  morbid  conditions, 


EXERCISE. 


123 


One  of  these  conditions,  and  probably  the  most  prevalent 
one,  and  certainly  the  one  most  generally  overlooked  or  un- 
thought  of  by  medical  men,  is  an  inactive  state  of  the  abdomi- 
nal muscles.  With  all  sedentary  persons  this  is  one  of  the 
essential  matters  to  be  attended  to  in  the  treatment.  As  has 
been  already  explained,  no  one  can  have  a  normal  action  of  the 
bowels  unless  the  muscles  which  constitute  the  walls  of  the  ab- 
domen co-operate  with  the  peristaltic  action  of  the  intestinal 
tube.  Dyspeptics  may  exercise  in  vain,  in  a  hundred  ways, 
unless  their  muscles  are  brought  into  action  and  invigorated. 
And  there  is  one  method  of  exercising  these  torpid  muscles 
which  all  dyspeptics  can  resort  to  with  advantage  without  the 
aid  of  doctors  or  machinery,  and  which  is  one  of  the  best 
" movement  cures"  ever  invented.  I  mean,  slapping  the 
abdominal  muscles  with  the  flat  hand.  The  slapping  should 
be  very  gentle  at  first,  so  as  to  cause  no  pain,  and  gradually 
increased  in  force,  as  the  muscles  become  active  and  elastic. 
Dyspeptics  who  are  so  tender  over  the  liver  or  stomach  that  the 
weight  of  ones  hand  is  painful,  can  in  a  few  weeks  or  months, 
by  persevering  slapping,  endure  a  blow  that  would  do  credit  to 
a  pugilist  without  inconvenience  or  injury.  The  exercise  may 
be  advantageously  varied  with  rubbing  and  kneading  ;  and, 
after  a  while,  when  the  tenderness  is  overcome,  by  pounding 
with  the  fist,  the  rule  of  beginning  gently  and  gradually  increas- 
ing the  force  being  observed.  The  muscles  of  the  loins  and 
around  the  small  of  the  back  should  also  be  exercised  in  the 
same  way,  which  can  easily  be  done  with  the  back  of  the  hand. 
This  simple  exercise  alone  has  effected  some  "  astonishing 
cures"  and  is  better  for  feeble  invalids  than  all  the  appliances 
of  a  regular  gymnasium.  Very  feeble  dyspeptics  should  have 
these  exercises  passively,  that  is,  made  by  an  attendant. 

Some  forty  years  ago,  a  Mr.  Halstead,  of  New  York,  effected 
some  wonderful  cures  of  feeble  and  emaciated  dyspeptics, 
whose  physicians  had  given  them  over  to  death,  by  a  process 
of  "kneading  the  bowels."  He  afterwards  invented  an  exer- 
cising chair  to  accomplish  the  same  result.    But  the  kneading, 


124 


DYSPEPSIA. 


pounding,  and  slapping  are  much  better  than  the  chair,  besides 
being  more  economical  and  always  available. 

The  following  case,  which  occurred  just  forty  years  ago, 
illustrates  the  principle  we  are  considering :  Two  of  my 
schoolmates,  eighteen  and  twenty-one  years  of  age  respectively, 
declined  in  health.  The  family  physician  called  their  ailment 
dyspepsia,  and  attended  them  one  year.  They  grew  no  bet- 
ter. Then  Thomsonian,  root  and  Indian  doctors,  far  and  near, 
tried  their  steaming  and  compounds  in  vain.  The  young  men 
continued  to  decline.  Both  were  extremely  emaciated  and  the 
younger  was  unable  to  sit  up.  The  elder  brother  suffered  ex- 
crutiatingly  at  times  of  colic,  and,  becoming  convinced  that  he 
could  not  recover,  in  one  of  his  unendurable  paroxysms,  com- 
mitted suicide  by  cutting  his  throat.  A  few  days  after  this 
tragedy  Mr.  Halsted  was  heard  of.  A  messenger  was  posted 
to  New  York,  who  paid  a  fee  of  $100;  took  a  solemn  oath 
not  to  disclose  the  secret,  nor  to  apply  it  to  any  person  but  this 
individual  patient,  the  younger  brother.  All  medicine  was 
discontinued  ;  the  regimen  was  the  same,  and  the  manipula- 
tions were  commenced.  In  a  couple  of  weeks  the  skeleton- 
patient  was  able  to  sit  up.  In  a  couple  of  months  he  was 
walking  about.  In  one  year  he  was  in  the  enjoyment  of  good 
health.     He  is  at  this  writing  a  Christian  minister. 

Another  case  of  recent  date  is  worth  relating,  as  showing  the 
benefit  and  the  necessity  for  restoring  the  action  of  the  abdom- 
inal muscles  in  desperate  cases  of  dyspepsia.  A  merchant  of 
Western  New  York  visiting  New  York  City  on  business,  called 
on  me  for  advice.  He  was  one  of  the  most  miserable  speci- 
mens of  this  miserable  class  of  invalids  that  I  ever  saw — ema-  i 
ciated,  the  abdomen  gaunt,  and  the  muscles  rigid,  bowels 
torpid,  and  troubled  with  flatulence  continually  and  colic 
frequently.  All  that  he  could  eat  without  unendurable  pain  in 
the  stomach  was  a  small  slice  of  stale  bread  and  a  bit  of  lean 
meat,  and  this  meagre  allowance  usually  occasioned  so  much 
gastric  irritation  that  he  had  acquired  the  habit  of  taking  a 
teaspoonful  of  brandy  after  each  meal.  He  suffered  constantly 
of  hunger  and  could  sleep  very  little.    Like  the  majority  of 


EXERCISE. 


I25 


such  persons,  he  was  in  the  pursuit  of  some  nostrum  or  remedy 
that  would  impart  to  him  health,  while  he  continued  to  live  and 
act  in  disobedience  to  all  the  conditions  of  health.  He  had 
destroyed  his  health  in  the  eager  pursuit  of  riches,  and  while 
intelligent  in  the  ways  and  means  by  which  property  could  be 
acquired,  he  was  totally  ignorant  of  nearly  all  the  ways  and 
means  by  which  his  own  vital  organs  could  be  preserved.  In 
ruining  his  health  he  had  accumulated  a  hundred  thousand 
dollars,  and  he  made  the  remark,  incidentally,  that  if  he  could 
recover  his  health  at  once  he  would  be  willing  to  give  a  thou- 
sand dollars  ! 

I  explained  to  him  the  nature  of  his  malady,  and  called 
attention  to  his  torpid  and  rigid  abdominal  muscles  as  the  chief 
feature  of  his  case.  As  my  Hygeio-Therapeutic  College  was 
then  in  session,  and  as  it  happened  to  be  one  of  the  evenings 
for  exercises,  I  invited  him  to  the  lecture  hall.  Some  of  the 
students  were  dancing  the  Schottische,  and  I  explained  to  him 
how  that  method  of  "  tripping  the  light  fantastic  toe"  was 
admirably  calculated  to  bring  into  action  the  torpid  muscles  of 
dyspeptics  affected  as  he  was.  Other  exercises  might  be  equally 
useful,  but  this  was  one  exactly  adapted  to  his  particular  con- 
dition. He  watched  the  terpsichorean  performance  with  as 
much  interest,  probably,  as  he  had  often  regarded  the  move- 
ments in  fancy  stocks.  One  year  afterwards  he  called  on  me 
again.  He  was  in  fair  health.  He  had  learned  the  steps,  and 
had  danced  the  dyspepsia  all  away. 

Walking,  horseback-riding,  and  rowing,  are  among  the  use- 
ful exercises  for  dyspeptics,  but  are  no  better  than  sawing  wood, 
working  in  the  garden,  washing  and  ironing,  only  as  they  may 
be  more  amusing  to  the  patient.  But  the  rule  here,  as  in  danc- 
ing, or  gymnastics  of  any  kind,  is  to  commence  very  mode- 
rately, and  be  regular  and  systematic.  It  is  on  account  of  their 
being  more  orderly  and  better  systematized  that  the  health-lift, 
dumb-bells,  Indian  clubs,  and  various  calisthenic  exercises  are 
so  frequently  preferable.  Many  useful  instructions  in  manual 
exercises  of  all  kinds  may  be  found  in  my  work  entitled,  "The 
Illustrated  Family  Gymnasium." 


126 


DYSPEPSIA. 


Invalids  who  undertake  to  regulate  their  own  exercises  al- 
most invariably  overdo  at  first.  Wishing  to  "  hurry  up  the 
cure,"  they  strain  some  part  of  the  muscular  system  and  actu- 
ally retard  it.  "  Make  haste  slowly/'  is  the  safe  rule.  Those 
who  are  subject  to  prolapsion  of  the  lower  portion  of  the  bowel, 
or  to  bleeding  piles,  can  scarcely  be  too  moderate  for  a  month 
or  so  in  every  new  kind  of  exercise  which  they  resort  to.  The 
reason  is,  that  as  the  vigor  and  elasticity  of  some  sets  of  mus- 
cles are  much  weaker  than  others,  and  the  whole  muscular  sys- 
tem unbalanced,  it  takes  time,  practice,  and  much  patience  to 
get  them  all  acting  harmoniously.  Some  persons  with  weak 
digestive  organs  and  enfeebled  respiratory  apparatus,  have  com- 
paratively strong  limbs.  They  can  walk  miles  without  great 
fatigue  of  the  muscles  of  locomotion  ;  while  a  smart  run  of 
thirty  feet,  or  a  quick  step  up  a  flight  of  stairs,  makes  the  heart 
flutter  and  the  breathing  laborious.  Such  invalids  need  very 
little  of  the  walking  but  much  of  various  other  exercises.  They 
should  practice  going  up  and  down  stairs  and  over  uneven 
surfaces  frequently,  always  keeping  the  mouth  shut,  and  never 
exercising  with  sufficient  violence  to  feel  the  necessity  of  open- 
ing the  mouth.  And  this  practice  should  be  persevered  in  until 
they  can  go  up  two  flights  of  stairs  on  the  "  double-quick  '* 
without  occasioning  shortness  of  breath  or  palpitation.  An 
excellent  "movement-cure"  process,  and  one  available  to  every 
invalid  who  can  walk,  is  to  strike  the  abdominal  muscles  with 
the  flat  hand,  and,  after  a  little,  with  both  hands,  while  walk- 
ing ;  the  blows  to  be  exactly  synchronous  with  the  contact  of 
the  sole  of  the  foot  with  the  ground  or  floor,  the  glottis  to  be 
closed  and  the  breath  held  at  the  moment  the  blow  and  step 
are  made.  This  compound  gymnastic  exercise  gives  a  remark- 
able spring  to  the  muscles  of  the  abdominal  walls,  as  any  one 
can  ascertain  by  making  the  experiment  properly.  This  move- 
ment can  be  practiced  with  still  greater  effect  while  walking  up 
and  down  stairs. 

Those  who  have  very  weak  lungs,  or  who  are  predisposed  to 
consumption,  should  resort  chiefly  to  such  exercises  as  are 
especially  calculated  to  inflate  the  lungs  and  expand  the  chest, 


BATHING. 


127 


Whatever  else  they  do  or  omit  to  do,  there  is  no  hope  against 
final  consumption  except  in  keeping  the  lungs  well  filled  with 
atmospheric  air.  Pulling  against  weights,  tossing  and  catch- 
ing ball,  light  dumb-bells,  wands,  etc.,  are  adapted  to  their 
purpose.  One  of  the  best  exercises  without  the  aid  of  artificial 
machinery  is  this  :  Stand  erect,  with  the  arms  perpendicular  ; 
raise  the  hands  slowly,  keeping  the  arms  extended  till  they  meet 
palm  to  palm  over  the  head  ;  then  let  them  descend  as  slowly 
till  they  meet,  palm  to  palm,  behind  the  back,  or  in  front, 
alternating  these  positions.  The  arms  should  go  up-and-down 
to  correspond  with  the  respirations — fifteen  to  twenty  per  min- 
ute. Inhalation  should  take  place  as  the  arms  ascend,  and 
expiration  as  they  descend. 


CHAPTER  XVIII. 
BATHING. 

The  majority  of  dyspeptics  require  very  little  ' '  water-treat- 
ment." Before  their  cases  come  under  the  cognizance  of  the 
physician,  their  circulation  is  low  and  nerves  enfeebled.  In 
nine  of  every  ten  of  these  cases  a  proper  dietary,  or  a  judicious 
plan  of  exercise,  is  vastly  more  important  than  bathing,  pro- 
vided any  part  of  the  remedial  plan  must  be  neglected.  Yet 
bathing  is  in  itself  important,  and  in  some  cases  will  ensure 
success,  when  without  it  all  other  measures  might  fail.  In  the 
early  days  of  "Hydropathy,"  packs,  plunges,  douches,  and 
umschlags  were  overdone,  on  the  false  theory  that  disease  was 
an  entity,  or  a  something  at  war  with  vitality,  which  must  be 
expelled  or  cast  out  by  a  '  *  crisis. "  And  even  in  these  days  of 
"  Hygienic  "  institutions  and  Hygeian  "  Homes,"  wet-girdles, 
chest-wrappers,  and  head-caps  are  too  much  employed  on  the 
absurd  notion  of  drawing  out  disease,  or  purifying  the  blood 
through  an  artificial  depurating  surface.  "Do  thyself  no 
harm  "  is  the  first  principle  and  the  universal  rule  for  managing 
the  bathing  part  of  the  treatment. 


128 


DYSPEPSIA. 


Not  many  years  ago  prolonged  and  very  cold  hip-baths — 
one  to  two  hours,  temperature  50  degrees  or  below,  were  fre- 
quently prescribed  as  ''tonic/'  "derivative,"  or  "  sedative 
processes,  on  the  erroneous  supposition  that  water  was  in  some 
sense  a  substitute  for  medicine.  Such  "heroic  "  management 
never  failed  to  exhaust  vital  power  and  aggravate  the  malady, 
when  it  did  not  change  it  to  some  new  form  or  worse  compli- 
cation. 

Within  a  few  years  past,  the  invalid  public,  always  running 
to  extremes  in  everything,  have  been  blundering  just  as  absurdly 
the  other  way  ;  and  very  hot  treatment — Turkish,  Russian, 
etc.,  baths,  have  become  the  prevailing  mania.  They  are 
more  agreeable  at  first,  but  more  debilitating  in  the  end  than 
were  the  extremely  cold  water  processes.  I  have  known  many 
feeble  dyspeptics  killed  by  them,  and  several  who  were  in  the 
incipient  stages  of  consumption  hurried  rapidly  to  their  graves 
by  them. 

The  limits  of  this  work  will  not  permit  me  to  explain  in  de- 
tail all  the  bathing  processes,  nor  even  mention  all  of  their 
applications  to  all  forms  and  conditions  of  ill-health,  but  I  must 
refer  those  who  desire  fuller  information  on  the  subject  to  my 
small  work,  "The  Bath  ;  its  Uses,"  etc. 

It  is  impossible  to  give,  in  a  work  of  this  kind,  anything  more 
than  a  plan  or  set  of  rules  to  regulate  the  water-treatment,  for 
the  reason  that  the  conditions  of  the  patients  are  so  different ; 
what  is  best  for  one  may  be  worst  for  another  ;  one  patient  may 
be  benefited  by  some  form  of  bath  once  or  twice  a  day,  while 
another  would  be  injured  by  any  bath  applied  more  frequently 
than  once  or  twice  a  week. 

The  following  summary  of  such  processes  as  can  be  man- 
aged in  home-treatment,  and  such  rules  as  all  should  observe, 
will  serve  as  a  chart  or  guide  for  the  dyspeptic  : 

Wet  Sheet  Packing. — On  a  bed,  or  matress,  two  or  three  comfortable? 
or  bedquilts  are  spread  ;  over  them  a  pair  of  flannel  blankets  ;  and,  lastly, 
a  wet  sheet  (rather  coarse  linen  is  best)  wrung  out  lightly.  The  patient, 
undressed,  lies  down  flat  on  the  back,  and  is  quickly  enveloped  in  the  sheet, 
blankets,  and  other  bedding.    The  head  must  be  well  raised  with  pillows, 


BATHING. 


129 


and  care  must  be  taken  to  have  the  feet  well  wrapped.  If  the  feet  do  not 
warm  with  the  rest  of  the  body,  a  jug  of  hot  water  should  be  applied  ;  and 
if  there  is  a  tendency  to  headache,  several  folds  of  a  cold,  wet  cloth,  should 
be  laid  over  the  forehead.  The  usual  time  for  remaining  in  the  pack  is 
from  forty  to  sixty  minutes.  It  may  be  followed  by  the  plunge,  half-bath, 
rubbing  wet -sheet,  or  towel-wash,  according  to  circumstances. 

Half-Pack. — This  is  the  same  as  the  preceding,  with  the  exception  that 
the  neck  and  extremities  are  not  covered  by  the  wet  sheet,  which  is  applied 
merely  to  the  trunk  of  the  body,  from  the  arm-pits  to  the  hips. 

Half-Bath. — An  oval  or  oblong  tub  is  most  convenient,  though  any 
vessel  allowing  a  patient  to  sit  down  with  the  legs  extended  will  answer. 
The  water  should  cover  the  lower  extremities  and  about  half  the  abdomen. 
While  in  the  bath  the  patient,  if  able,  should  rub  the  lower  extremities  while 
the  attendant  rubs  the  chest,  back,  and  abdomen. 

Hip  or  Sitz  Bath. — Any  small-sized  wash-tub  will  do  for  this,  although 
tubs  constructed  with  a  straight  back,  and  raised  four  or  five  inches  from  the 
floor,  are  mucli  the  most  agreeable.  The  water  should  just  cover  the  hips 
and  the  lower  part  of  the  abdomen.  A  blanket  should  be  thrown  over  the 
patient,  who  will  find  it  also  useful  to  rub  or  knead  the  abdomen  with  the 
hand  or  fingers  during  the  bath. 

Foot-Bath. — Any  small  vessel,  as  a  pail,  will  answer.  Usually  the 
water  should  be  about  ankle  deep.  During  the  bath,  the  feet  should  be 
kept  in  gentle  motion.  Walking  foot-baths  are  excellent  in  warm  weather, 
where  a  cool  stream  can  be  found.  The  hot -and  cold  foot  bath  consists  in 
holding  the  feet  in  water  as  warm  as  can  well  be  borne— five,  ten,  or  fifteen 
minutes — then  dipping  them  a  moment  in  cool  or  cold  water,  and  wiping 
dry. 

Rubbing  Wet-Sheet.— If  the  sheet  is  dripping  wet,  the  patient  stands 
in  the  tub  ;  if  wrung  so  as  not  to  drip,  it  may  be  used  on  a  carpet,  or  in 
any  place.  The  sheet  is  thrown  around  the  body,  which  it  envelops  below 
>ie  neck  ;  the  attendant  rubs  the  body  over  the  sheet  (not  with  it),  the 
patient  exercising  himself  at  the  same  time  by  rubbing  in  front. 

Pail-Douche. — This  means  simply  pouring  water  over  the  sheet  and 
shoulders  from  a  pail. 

Stream-Douche.- -A  stream  of  water  may  be  applied  to  the  part  or 
parts  affected,  by  pouring  from  a  pitcher  or  other  convenient  vessel,  held 
as  high  as  possible  ;  or  a  barrel  or  keg  may  be  elevated  for  the  purpose, 
having  a  tub  of  any  desired  size.  The  power  will  be  proportional  to  the 
a  nount  of  water  in  the  reservoir. 


Towel  or  Sponge-Bath.— Rubbing  the  whole  surface  with  a  coarse, 


13° 


DYSPEPSIA. 


wet  towel  or  sponge,  followed  by  a  dry  sheet  or  towel,  constitutes  this  pro- 
cess. 

The  Wet  Girdle. — Three  or  four  yards  of  crash  toweling  make  a  good 
one.  One-half  of  it  is  wet  and  applied  around  the  abdomen,  followed  by 
the  dry  half  to  cover  it.    It  should  be  wetted  as  often  as  it  becomes  dry. 

The  Chest -Wrapper. — This  is  made  of  crash,  to  fit  the  trunk  like  an 
under-shirt,  from  the  neck  to  the  lower  ribs  ;  it  is  applied  as  wet  as  possible 
without  dripping,  and  covered  by  a  similar  dry  wrapper,  made  of  Canton  or 
light  woolen  flannel.    It  requires  renewing  two  or  three  times  a  day . 

The  Sweating-Pack. — To  produce  perspiration  the  patient  is  packed  in 
the  flannel  blanket  or  other  bedding,  as  mentioned  in  the  Wet-Sheet  Pack, 
omitting  the  wet  sheet.    Some  perspire  in  less  than  an  hour  ;  others  re- 
quire several  hours.    This  is  the  severest  of  water-cure  processes,  ar 
in  fact,  is  very  seldom  called  for. 

The  Plunge- Bath.— This  is  employed  but  little,  except  at  the  Esta- 
blishments. Those  who  have  conveniences  will  often  find  it  one  of  the  best 
processes.  Any  tub  or  box  holding  water  enough  to  allow  the  whole  body 
to  be  immersed,  with  the  limbs  extended,  answers  the  purpose.  A  very 
good  plunge  can  be  made  of  a  large  cask  cut  in  two  near  the  middle.  It 
is  a  useful  precaution  to  wet  the  head  before  taking  a  bath. 

The  Shower-Bath. — This  needs  no  description.  It  is  not  frequently 
used  in  treatment,  but  is  often  very  convenient.  Those  liable  to  a  "rush 
of  blood  to  the  head,"  should  not  allow  much  of  the  shock  of  the  stream 
upon  the  head.  Feeble  persons  should  never  use  this  bath  until  prepared 
by  other  treatment. 

Fomentations. — These  are  employed  for  relaxing  muscles,  relieving 
spasms,  griping,  nervous  headache,  etc.  Any  cloths  wet  in  hot  water 
and  applied  as  warm  as  can  be  borne,  generally  answer  the  purpose  ;  but 
flannel  cloths  dipped  in  hot  water,  and  wrung  nearly  dry  in  another  cloth  or 
handkerchief,  so  as  to  steam  the  part  moderately,  are  the  most  efficient 
sedatives. 

Injections. — These  are  warm  or  tepid,  cool  or  cold.  The  former  are 
used  to  quiet  pain  and  produce  free  discharge  ;  the  latter  to  check  excessive 
evacuations  and  strengthen  the  bowels.  For  the  former  purpose  ~  large 
quantity  should  be  used  ;  and  for  the  latter  a  small  quantity. 

General  Bathing  Rules.— Never  bathe  soon  after  eating.  The  most 
powerful  baths  should  be  taken  when  the  stomach  is  most  empty.  No  full 
bath  should  be  taken  less  than  three  hours  after  a  full  meal.  Great  heat 
or  profuse  perspiration  are  no  objections  to  going  into  cold  water,  provided 
the  respiration  is  not  disturbed,  and  the  patient  is  not  greatly  fatigued  or 


BATHING. 


exhausted.  The  body  should  always  be  comfortably  warm  at  the  time  of 
taking  any  cold  bath.  Exercise,  friction,  dry  wrapping,  or  fire  may  be  re- 
sorted to,  according  to  circumstances.  Very  feeble  persons  should  com- 
mence treatment  with  warm  or  tepid  water,  gradually  lowering  the  tempe- 
rature. 

The  temperature  of  baths  should  always  be  regulated  by  the 
temperature  of  the  patient.  Very  feeble  invalids  should  never 
take  very  hot  nor  very  cold  baths  of  the  whole  surface,  although 
hot  or  cold  applications  may  be  made  locally  to  relieve  spasms 
or  check  discharges.  Dyspeptics  who  are  not  emaciated  and 
are  not  disposed  to  chilliness  may  take  a  tepid  ablution — 70  to 
8c  degrees — each  morning,  and  a  hip  bath  each  afternoon  for 
ten  minutes,  at  75  to  85  degrees.  For  feebler  persons  the  tepid 
ablution  or  wet  rubbing  sheet  each  other  day  is  sufficient,  with 
the  hip-bath  on  the  alternate  day.  Still  feebler  persons  may 
take  the  tepid  rubbing  sheet  one  day,  the  dry  rubbing  sheet  the 
second  day,  and  the  hip-bath  the  third  day,  and  so  on  ;  and  il 
extremely  feeble  the  wet  rubbing  sheet  should  only  be  employ- 
ed once  a  week,  and  the  dry  rubbing  sheet  on  the  other  days. 
The  dry  rubbing  sheet  is  practically  an  air-bath,  and  has  never 
been  sufficiently  appreciated  in  or  out  of  health  institutions. 

Sun-baths  are  among,  the  best  appliances  in  self-treatment, 
as  most  patients  can  manage  them  without  assistance.  All 
that  is  needed  is  a  sunshiny  place,  in-doors  or  out,  where  the 
temperature  is  agreeable.  The  patient  has  only  to  expose  the 
naked  body  to  the  sunlight  and  make  gentle  friction  over  the 
whole  surface  with  dry  towels,  or  a  sheet,  for  five  to  ten  min- 
utes. 

*  For  bathing  purposes,  as  for  drinking  and  cooking,  there  is 
a  great  difference  between  pure  and  hard  water.  Hard  and 
impure  water  may  be  better  than  none,  but  the  rule  is,  the 
purer  the  better. 


*3* 


DYSPEPSIA. 


CHAPTER  XIX. 
CLOTHING. 

So  far  as  the  recovery  of  health  is  concerned,  the  dyspeptic 
has  only  to  dress  in  the  most  comfortable  manner  possible  to 
insure  the  best  possible  results.  But  fashion  has  so  demoral- 
ized judgment,  perverted  taste,  and  enslaved  the  minds  of  our 
people  that  it  seems  necessary  to  say  a  good  deal  on  this  sub- 
ject, in  addition  to  what  has  been  said  and  illustrated  in  the 
first  part  of  this  work  ;  and  as  the  young  ladies  all  over  our 
country  are  going  to  rum  in  droves  because  of  the  unwhole- 
some garments  that  they  put  on,  a  few  more  "  lines  upon  lines 
and  precepts  upon  precepts,  '  may  not  be  inappropriate, 

We  should  always  keep  in  mind  that  clothing  can  never 
impart  heat  to  the  body  ;  it  only  retains  the  heat  which  the 
body  imparts,  which  heat  of  the  body  is  owing  to  the  circulation. 
The  better  the  conducting  material  of  clothing  the  more  readily 
the  heat  of  the  body  passes  through  it ;  and  the  more  non- 
conducting the  material  the  longer  the  heat  is  retained  ;  hence 
in  warm  weather,  linen  and  cotton,  and  in  cold  weather  woolen 
and  fir,  are  best  adapted  to  maintaining  an  equilibrium  of 
bodily  temperature. 

Says  a  writer  in  the  Science  of  Health  : 

"  We  can  easily  understand  how  a  delicate  woman,  weighed  down  by  a 
mass  of  heavy  clothing  that  would  fatigue  a  strong  man,  with  all  her  phys- 
'  ical  powers  depressed  and  her  circulation  reduced  to  a  low  ebb,  should 
shiver  with  cold,  within  the  most  abundant  wrappings.  Do  not  make  the 
mistake  of  supposing  that  a  heavy  fabric  is  necessarily  a  warm  one.  It  is  a 
fact  that  a  few  folds  of  light  fleecy  material  thrown  loosely  together  are 
a  much  more  efficient  protection  against  cold  than  a  double  thickness,  even, 
of  some  stuff  four  times  its  weight,  and  as  compact  as  a  board.  Let  wool 
and  fur,  both  in  their  natural  shape  bad  conductors  of  heat  and  therefore 
well  calculated  to  preserve  the  natural  warmth  of  the  body,  enter  largely 
into  the  attire,  and  in  as  light  a  form  as  possible  ;  refuse  positively  to  don  a 
garment  of  any  sort  in  any  weather,  whose  shape  and  weight  shall  impede 
the  movements  or  cause  the  least  sensation  of  fatigue  in  wearing  it,  and  above 
all  avoid  weighing  down  the  hips  with  the  multiplicity  of  skirts  which  are 


CLOTHING. 


133 


the  abomination  of  the  present  age  of  dress  ;  give  the  shoulders  their  proper 
share  of  the  weight  of  the  clothing  to  sustain  ;  allow  no  uncomfortable 
restrictions  to  impede  the  free  action  of  the  organs  of  breathing  and  circu- 
lation, and  you  may  bid  farewell  to  pains  in  the  back  and  shoulders,  to 
headache,  and  to  diificulty  of  breathing  ;  you  will  ride  less  and  walk  more, 
for  walking  will  then  be  a  pleasure,  instead  of  an  almost  impossible  task, 
as  it  is  to  a  fashionably  dressed  woman  now-a-days." 

The  Washington  Star  newspaper  makes  the  following  re- 
port of  a  lecture  recently  delivered  in  the  Congregational 
Church  of  that  city,  by  Mrs.  Chandler.  It  is  certainly 
<k  plain  talk,"  but  as  it  is  talk  that  every  person  ought  to 
hear,  and  this  book  is  intended  for  everybody  to  read,  it 
may  be  properly  recorded  in  this  place  : 

"  Our  denaturalized,  deformed,  depraved  tastes  render  us  an  easy  prey 
to  the  tricks  of  the  tradesmen  on  both  sides  of  the  water.  Suppose  our 
dwellings  to  be  constructed  upon  a  model  planned  across -the  ocean,  with- 
out reference  to  our  climate,  our  American  modes  of  living,  our  physical  de- 
mands, our  means,  our  health  or  our  comfort.  Yet  that  is  the  stupid 
way  in  which  we  are  led  in  that  which  comes  nearer  to  us  than  our 
houses— the  dress  we  wear. 

"  Our  grandmothers  have  injured  this  whole  generation  with  their  broad- 
board  corset,  and  we,  already  diseased  from  many  other  causes  beside, 
and  lacking  their  plumpness  and  beauty,  are  completing  the  wreck  by 
binding  and  pinching  and  pressing  and  padding  until  the  woman  who  re- 
tires at  night  is  so  unlike  the  one  who  walked  by  day  that  we  need  not 
wonder  that  the  bridegroom,  frightened  by  the  dissolving  view,  does  not 
know  which  is  the  bride,  the  clothes  or  the  woman. 

'k  The  dress  of  the  Friends  is  simple  enough,  but  proves  to  be  neither  eco- 
nomical nor  convenient.  The  Primitive  Methodist  dress,  designed  to  be 
repulsive,  died  away  for  lack  of  beauty.  When  man  was  recognized  as 
creator  of  the  child,  master  of  the  woman,  and  disposer  of  the  daughter, 
he  arrayed  himself  accordingly  in  gorgeous  apparel  ;  but  with  the  partial 
elevation  of  woman  his  pride  has  taken  a  new  departure,  and  the  average 
American  man  now  takes  pride  in  the  dress  of  his  wife.  While  he  consults 
freedom,  ease,  convenience  and  health  in  his  own  dress,  he  is  glad  to  know 
that  his  wife  and  daughters  represent  his  resources  in  their  wardrobe. 

"  Emily  Faithfull  says  the  larger  number  of  those  who  come  to  her  in  ex- 
treme destitution  for  assistance  to  obtain  employment  are  widows  and  daugh- 
ters of  clergymen  and  other  men  of  moderate  mcome  who  have  been  ac- 
customed to  being  supported,  and  had  never  learned  any  means  whatever 
of  earning,  accumulating,  investing  or  saving.  Philanthropic  women  in 
our  own  country  give  the  same  testimony.    It  is  but  a  step  from  helpless 


134 


DYSPEPSIA. 


destitution  to  hopeless  degradation.  Women  in  this  Republic  have  esta- 
blished a  caste  in  dress  which  makes  a  young  woman  whose  father  has  an 
income  of  $1,500  feel  that  she  must  compete  with  the  young  lady  whose 
father  has  $15,000  per  annum,  and  the  girl  who  earns  $5  a  week  must  in 
all  respects  keep  pace  with  the  one  who  receives  $15  a  week. 

"  The  demands  of  fashion  are  more  imperative  than  the  demands  of  virtue, 
and  a  young  lady  feels  more  disgraced  by  an  unfashionable  garment  than 
by  soiled  under  clothing  or  dilapidated  morals.  Grinder  &  Co.,  willing  to 
swell  the  list  of  lost  sheep,  offer  a  young  lady  $3  a  week  for  constant  labor, 
and  when  she  states  that  it  is  impossible  to  even  purchase  food  and  shelter  for 
that  sum,  they  politely  inquire  if  she  has  not  some  gentleman  friend  who 
will  make  up  the  balance  ;  or,  still  more  blandly,  'We  will  give  you  $20  a 
week,  and  you  need  net  work  at  all.'  " 

We  need  only  remark,  in  concluding  this  chapter,  that 
tight  shoes  or  boots  are  two  evils  that  should  be  avoided  by 
all  who  would  keep  well,  and  especially  by  all  dyspeptics 
who  would  regain  health.  Tight-fitting  shoes  or  boots  con- 
duce to  coldness  of  the  feet,  a  symptom  that  always  troubles 
feeble  invalids  in  cold  weather  ;  while  high  heels  throw  the 
whole  body  out  of  perpendicularity,  and  render  all  exercises, 
more  especially  walking,  net  only  less  pleasant  and  less  bene- 
ficial, but  in  some  instances  positively  injurious.  Let  a  feeble 
person,  accustomed  to  walk  one  mile  a  day  over  heels  one 
inch  thick,  reduce  the  thickness  to  one-third  of  an  inch,  and 
he  may  experience  at  once  the  difference  between  laborious 
toil,  and  agreeable  and  useful  recreation 

Nothing  can  be  said  in  favor  of  the  "stove-pipe"  hat  which 
has  so  long  oppressed  the  heads  of  men  ;  it  is  conducive  to  con- 
gestion of  the  brain  in  some  degree,  baldness,  and  in  persons 
predisposed  to  apoplexy  actually  dangerous.  Whatever  is 
worn  on  the  head  should  be  light  and  soft,  or  ' '  softening  of 
the  brain  n  may  be  the  final  result. 

In  behalf  of  dyspeptic  clergymen  I  must  protest  against  the 
unhygienic  manner  in  which  fashion  has  dressed  their  necks  : 
and  as  an  article  in  the  Christian  Advocate  expresses  the  right 
sentiments,  I  quote  : 

Ministers'  Cravats. 

"  Who  but  Satan  could  ever  have  invented  a  'minister's  choker?'  The 
idea  of  tying  a  band,  a  cravat,  or  anything  else  chicly  alxwt  the  throat, 


CLOTHING. 


135 


thus  paralyzing  all  the  organs  of  the  voice,  is  absurd  and  cruel  in  the  ex- 
treme. Let  the  neck  be  free  ;  and  let  all  the  bands  around  it  be  from  one 
to  two  inches  larger  than  the  neck  itself.  If  a  collar-band  is  close, 
unbutton  it.  The  neck  will  expand  nearly  an  inch  when  the  veins  are  sur- 
charged with  blood  during  the  active  mental  and  bodily  exercise  of  public 
speaking.  Then  a  loose  collar  becomes  close,  and  the  swollen  veins,  press- 
ing against  the  cravat,  are  unable  to  bring  back  to  the  heart  the  blood 
which  the  arteries  have  conveyed  to  the  head.  The  arteries  keep  pouring 
their  flood  into  the  head  ;  the  veins  swell,  and  cannot  return  it  ;  the  blood 
dams  up,  a  dark  and  livid  flood  ;  the  face  looks  red  and  purple  ;  thought 
ceases,  ideas  vanish,  words  fail,  and  the  preacher  is  confused,  stammers, 
and  'breaks  down.' 

"'Result  of  extempore  preaching,'  says  one;  'Embarrassment,'  says 
another;  'better  stick  to  the  manuscript.'  Fudge!  it  is  simply  a  close 
cravat— such  a  rigging  would  choke  an  apostle,  and  no  man  can  preach 
when  he  is  choked. 

"  The  throat  is  a  wonderful  instrument  of  music.  Place  the  fingers  upon 
it,  and  every  time  you  speak  you  can  feel  the  vibration  of  the  vocal  organs, 
producing  sound.  Anything  that  even  touches  the  throat  impairs  the 
purity  of  these  sounds.  Fling  a  cloth  over  the  strings  of  a  piano  or  violin, 
and  get  music  out  of  it  if  you  can.  So  every  cloth  which  surrounds  the 
throat  impairs  the  sweetness  of  the  voice.  Women  go  with  necks  bare- 
men  have  theirs  swathed  and  bandaged,  and  ten  women  have  sweet  voices 
where  one  man  has  one.  A  man's  voice  should  be  as  pure  as  a  woman's. 
Why  is  it  not  ?    He  is  shaved  and  choked. 

"  God  has  provided  a  covering  for  man's  throat — light  and  soft,  it  clothes 
the  neck  and  preserves  the  health  ;  but  a  man  gets  a  sharp  iron,  scrapes  his 
neck,  ties  a  rag  around  it,  takes  cold,  has  sore  throat,  bronchitis,  and  con- 
sumption, and  dies. 

"  Preacher  of  the  Gospel,  strike  for  freedom  and  for  life.  Fling  away 
the  razor.  Tarry  in  Jericho  till  your  beard  has  grown.  Throw  off  then, 
gradually,  but  entirely,  the  bandages  about  the  neck  ;  stand  erect,  breathe 
freely,  think,  speak,  and  act,  in  blissful  exemption  from  embarrassment, 
and  exemplify  what  a  man  can  be  who  fears  God  and  cuts  loose  from  the 
fashions  of  a  fleeting  world." 

The  sanitary  view  of  the  color  of  clothing  is  correctly  stated 
by  Dr.  Nichols  in  the  Journal  of  Chemistry  : 

"The  color  of  clothing  is  by  no  means  a  matter  of  indifference.  White 
and  light -colored  clothes  reflect  the  heat,  while  black  and  dark-colored 
ones  absorb  it.  White  is  the  comfortable  and  fashionable  color  for  clothing 
in  summer.  It  reflects  Heat  well,  and  prevents  the  sun's  rays  from  passing 
through  and  heating  the  body.  If  white  is  the  best  color  for  summer,  it 
(jges  not  follow  that  blacH  is  the  best  for  winter,    It  must  be  rememberec) 


136 


DYSPEPSIA. 


that  black  radiates  heat  with  great  rapidity.  Give  a  coat  of  white  paint  to 
a  black  steam  radiator,  which  is  capable  of  rendering  a  room  comfortably- 
warm  at  all  times,  and  the  temperature  will  fall  at  once,  though  the  heat- 
producing  agency  remain  the  same  as  before.  A  black  garment  robs  the 
body  of  a  larger  amount  of  heat  than  white,  and  consequently  the  latter 
color  is  the  best  for  winter  garments.  It  is  the  best  color  for  both  summer 
and  winter.  Although  this  statement  may  seem  like  blowing  hot  and  cold, 
it  is  nevertheless  true.  Let  those  who  are  troubled  with  cold  feet,  and  who 
wear  dark  socks,  change  to  white,  and  see  if  the  difficulty  is  not  in  part  or 
wholly  removed. ' ' 


CHAPTER  XX. 
SLEEP. 

I  have  never  known  a  dyspeptic  invalid  who  could  sleep  too 
much  ;  but  I  have  known  many  whose  chief  burden  of  com- 
plaining was  sleeplessness.  The  rule  for  them  all  is,  sleep  as 
much  as  possible.  But  there  is  a  difference  between  dosing, 
dreaming,  or  lying  in  bed,  and  sleeping. 

It  is  a  physiological  law  that  assimilation  mainly  takes  place 
during  sleep.  When  the  mental  powers  are  in  repose,  the  food 
elements,  which  have  been  elaborated  by  the  digestive  processes 
during  the  day,  are  formed  into  tissues  and  structures.  The 
rapid  emaciation  of  the  body,  and  the  delirium  or  insanity 
which  affects  the  brain,  in  all  cases  of  protracted  wakefulness, 
prove  that  no  one  can  be  deprived  of  normal  sleep  without 
absolute  deterioration  of  health  and  certain  abbreviation  of 
life.  And  it  is  a  fact  that  ought  never  to  be  lost  sight  of  in 
managing  irritable  and  restless  dyspeptics,  that  the  nervous  tem- 
perament and  brain-labor  necessitate  a  greater  amount  of 
sleep,  than  do  the  vital,  or  motive  temperament  and  manual 
occupations. 

Sound  sleepers  are  generally  sound  thinkers,  for  the  reason  that 
the  wear  and  tear  of  brain  substance  is  well  renovated.  They 
are  also  powerful  workers  and  long-lived,  for  the  reason  tha 
the  waste  of  the  vital  organs  is  well  repaired.  And  it  may  be 
stated  as  an  invariable  law  of  life,  that  no  one  ever  did  or  evci 


SLEEP. 


137 


can  be  deprived  of  normal  sleep  without  detracting  correspond- 
ingly from  vigor  of  both  mind  and  body,  and  length  of  days; 

Much  is  said  in  these  days  of  fast  living,  commercial  energy, 
and  the  mad  pursuit  of  immediate  pleasures  and  sensuous 
indulgences,  of  overworked  brains,  as  a  cause  of  dyspepsia. 
The  true  cause  is,  abused  bodies.  The  brain  cannot  be  over- 
worked, provided  the  vital  conditions  are  properly  attended  to. 

A  few  years  ago  Dr.  Edward  Johnson,  of  London,  wrote  a 
book  in  which  he  maintained  the  paradoxical  positions  that 
' 'dyspepsia  is  not  a  disease  of  the  stomach  ;  constipation  is  not 
a  disease  of  the  bowels  !"  The  statements  are  simply  absurd  ; 
but  they  have  some  degree  of  plausibility  as  explained.  Dr. 
Johnson  argued,  that  as  mental  worryment,  a  feverish  anxiety 
to  get  rich,  too  close  attention  to  business  matters,  and  "  over- 
worked brains, "  were  among  the  chief  producing  causes  of  dys- 
pepsia, the  real  disease  was  in  the  brain  instead  of  the  digestive 
organs.  But  this  is  confounding  causes  and  consequences. 
Dyspepsia,  as  the  term  implies,  affects  primarily  and  principally 
the  digestive  organs,  be  the  causes  what  and  where  they  may. 

I  am  of  the  opinion  that,  taking  all  the  people  of  this  coun- 
try, or  of  the  whole  earth,  ten  persons  underwork  their  brains 
to  every  one  who  overworks  them  ;  and  that  ten  persons  over- 
work their  digestive  organs  to  every  one  who  underworks  them. 
Brain-work  is  in  itself  as  healthful  as  any  vocation  can  possibly 
be  ;  indeed,  a  certain  and  a  considerable  amount  of  it  is  essen- 
tial to  the  best  condition  and  highest  vigor  of  the  vital  organism. 

Dr.  Beard,  in  a  late  article  in  the  Independent,  makes  the 
following  judicious  observations  : 

"Persistent  sleeplessness  is  a  symptom  that  should  always  bring  home  to 
us  the  query  whether  we  are  not  in  some  way  overworked  or  overworried. 
Inability  to  sleep  is  one  of  the  most  constant  precursors  and  accompani- 
ments of  cerebral  exhaustion  and  decline.  I  have  been  informed  by  excel- 
lent and  direct  authority  that  Mr.  Greeley  stated  during  the  last  campaign 
that  for  fifteen  years  he  had  not  had  a  good  sound  sleep.  To  those  of  us 
who  have  been  accustomed  to  see  him  dozing  on  the  horse-cars,  in  the 
omnibuses,  and  at  church,  this  statement  seems  quite  surprising  ;  but  it  is 
probable  that  by  these  extemporaneous  naps  he  sought  to  make  up  for  the 
wakeful  hours  of  the  night.  x 


133 


DYSPEPSIA. 


"  Sleeplessness  is  oftentimes  the  prayer  of  the  cerebral  lobes  for  relief  from 
work  and  worry,  and  it  should  never  go  long  unanswered.  Some  of  the 
greatest  and  healthiest  natures  of  the  world— like  Goethe  and  Thorwaldsen — 
have  had  a  "  talent  for  sleeping,"  which  made  all  their  other  talents 
shine  at  their  best,  for  the  brain  is  never  so  brilliant  as  just  after  fully 
awaking  from  sound  repose.  Sir  Walter  Scott  found  by  experience  that 
his  mind  was  clearest  for  thinking  out  his  novels  just  after  rising,  and  for 
that  reason  he  took  pains  to  prolong  as  much  as  possible  his  morning  toi- 
let ;  and  in  the  same  way  we  may  explain  the  fact  that  Calvin  loved  to  com- 
pose while  lying  in  bed. 

•*  In  great  and  pressing  crises,  when  our  work  and  our  causes  for  worry 
are  trebled,  the  temptation  is  very  strong  to  cut  short  our  hours  of  sleep  ; 
but  these  are  just  the  occasions  when,  if  possible,  we  should  sleep  the  most. 
General  Grant  is  credited  with  the  statement  that  he  owed  the  preservation 
of  his  health  during  the  late  war  to  the  fact  that,  come  what  might,  he 
always  would  have  his  eight  or  nine  hours  sleep.  At  one  time,  during  the 
Vicksburg  campaign,  I  believe,  he  was  unable  to  obtain  this,  and  then  he 
began  to  suffer.  Gladstone  has  declared  that  when  he  enters  his  home  he 
leaves  the  cares  of  state  behind  him. 

"  Sleep  is  food  fcr  the  brain.  If  a  penny  saved  is  a  penny  earned,  then  to 
economize  nerve  force  by  rest  is,  within  certain  limits,  to  supply  nerve  force 
by  eating  and  drinking. 

"To  work  hard  without  overworking,  to  work  without  worrying,  to  do 
just  enough  without  doing  to*o  much— these  are  the  great  problems  of  the 
future.  Our  earlier  Franklin  taught  us  to  combine  industry  with  economy  ; 
our  *  later  Franklin  '  taught  us  to  combine  industry  with  temperance  ;  our 
future  Franklin  -  if  one  should  arise— must  teach  us  how  to  combine  indus- 
try with  the  art  of  taking  it  easy." 

Some  dyspeptics  will  sleep  best  the  fore  part  of  the  night, 
and  others  the  latter  part,  or  early  in  the  morning.  Such  pa- 
tients should  practice  "  early  to  bed  and  not  early  to  rise,  ' 
until  the  habit  of  regular  and  orderly  sleeping  is  acquired.  I 
hardly  need  say  that  such  persons  especially,  as  well  as  all 
other  persons  generally,  should  avoid  late  or  heavy  suppers,  and 
all  exciting  exercises,  occupations,  or  thoughts  after  sunset. 

Sleepless  dyspeptics  are  very  liable  to  cold  feet,  and  some- 
times despite  any  quantity  of  bedding.  In  such  cases  bottles 
of  hot  water,  bags  of  hot  sand,  or  hot  bricks  should  be  placed 
at  the  feet.  If  a  couple  of  bricks  are  well  heated,  and  wrapped 
in  two  or  three  folds  of  woolen  cloth,  they  will  remain  warn} 
ten  or  twelve  hours. 


VENTILATION. 


139 


CHAPTER  XXL 
VENTILATION. 

In  the  Chapter  on  Aeration,  in  the  first  part  of  this  work, 
we  have  seen  the  relation  of  respiration  to  nutrition.  The 
food  elements  can  never  be  properly  elaborated  without  free 
and  unimpeded  breathing  ;  nor  can  they  be  well  fitted  for 
assimilation  unless  the  air  be  pure.  The  impurities  in  the  air 
we  breathe,  like  those  in  the  water  we  drink,  or  in  the  food  we 
eat,  not  only  poison  the  blood  and  obstruct  the  organs  with 
foreign  matters,  but  prevent  the  proper  aeration  of  pabulum 
in  the  lungs.  In  both  of  these  ways  does  impure  air  tend  to 
derange  the  digestive  organs. 

But  another  very  common,  I  had  almost  said  universal 
source  of  blood  contamination,  is  the  re-inhalation  of  carbonic 
acid  gas  which  has  been  exhaled,  and  the  inhalation  of  the 
waste  matters  of  the  body  consequent  on  ill-ventilated  apart- 
ments. It  is  because  no  provision  is  made  for  ventilation  that 
so  many  tenement  houses  of  our  cities  are  so  pestilential,  ever 
breeding  typhoid  fevers  and  other  zymotic  diseases.  Our  com- 
mon school-houses,  not  being  quite  so  bad,  because  only 
occupied  during  a  part  of  the  day,  do  not  infect  their  inmates 
with  sufficient  rapidity  to  engender  acute  diseases,  but  are  foul 
enough  to  cause  a  variety  of  chronic  affections,  and  predispose 
to  dyspepsia  and  many  of  its  complications,  especially  those 
which  are  termed  scrofulous,  or  tuberculous,  bilious,  scorbutic, 
etc.  At  this  writing  the  Health  Department  of  New  York  City 
are  inspecting  school-houses,  factories,  and  public  buildings, 
with  the  view  of  ascertaining  their  sanitary  conditions.  Dr.  E. 
H.  James,  City  Sanitary  Inspector,  made  a  report  to  the  Board 
of  Health,  a  few  days  ago,  from  which  I  make  the  following 
extract,  which  is  equally  applicable,  doubtless,  to  many  cities 
besides  the  commercial  emporium,  and,  I  fear  to  many  rural 
districts  : 

1 1  In  connection  with  the  recent  inspections  of  public  school  buildings 
and  factories,  made  by  the  Health  Inspectors,  I  directed,  on  the  3d  inst.,  Dr» 


140 


DYSPEPSIA. 


II.  Endemann,  Assistant  Chemist  of  the  Department,  to  collect  specimens 
of  air  from  a  few  of  the  schools  and  other  public  buildings,  and  submit  them 
to  chemical  analysis,  for  the  purpose  of  determining  the  amount  of  carbonic 
acid  and  other  impurities.  This  duty  he  has  performed,  and  I  herewith 
present  a  brief  abstract  of  his  report. 

"  The  following  places  were  visited  for  this  purpose  :  E.  C.  Higgins' 
carpet  factory,  foot  of  West  Forty-third-street  ;  Farren  &  Guetal's  felt 
factory,  No.  319  East  Twenty -second-street  ;  Johnson  &  Falckner's  hair- 
cloth factory,  Nos.  246  and  248  Sixth  Avenue  ;  Mellen  &  Co.'s  horse  hair, 
No.  518  East  Seventeenth-street  ;  Tombs  Prison  ;  Elm-street  School  ; 
Roosevelt -street  School ;  Thirteenth  street  School,  near  Seventh  Avenue  ; 
Thirteenth-street  School,  near  Sixth-avenue  ;  school,  Nos.  97  and  99 
Greenwich-street  ;  school  in  Vandewater-street ;  school  in  Madison-street, 
near  Jackson.  Specimens  of  air  obtained  from  two  of  the  factories  men- 
tioned were  examined  and  found  to  contain  from  14.7  to  16.7  parts  of  car- 
bonic acid  in  10,000  parts  of  air,  averaging  about  four  times  the  normal 
quantity,  which  is  4  parts  in  10,000. 

The  mechanical  impurities  generally  consisted  of  the  dust  arising  from  the 
operations  pursued,  and  were  either  of  an  organic  or  inorganic  nature.  Of 
the  former,  fine  sharp  pieces  of  hair,  by  irritating  the  mucous  membrane  of 
the  respiratory  organs,  form  the  most  frequent  source  of  bronchial  or 
pulmonary  affections  among  this  class  of  operatives. 

ik  The  air  in  the  male  department  of  the  Tombs  Prison  was  found  to  con- 
tain 14  7  parts  of  carbonic  acid  in  10,000  as  an  average  of  two  experiments, 
and  that  in  the  female  department  8.45  parts,  being  also  the  average  of 
two  experiments. 

"  From  our  public  schools  Dr.  Endemann  obtained  seventeen  samples  of 
air  the  examination  of  which  determined  the  presence  of  carbonic  acid, 
varying  in  amount  from  9.7  to  35.7  parts  in  10,000  or,  in  other  words, 
from  more  than  twice  to  nearly  nine  times  the  normal  quantity.  The  ven- 
tilation in  these  buildings  is  generally  faulty  and  can  be  obtained  only  by 
opening  the  windows,  a  practice  detrimental  to  the  health  of  the  children 
who  sit  near  or  directly  under  them.  The  following  experiments,  made  in 
the  Roosevelt -street  School,  shows  the  inefficiency  of  ventilating  flues 
in  the  wall  unprovided  with  means  for  creating  an  upward  current.  An 
examination  of  the  air  in  one  of  the  class-rooms  provided  with  a  ventilating 
flue,  was  made  while  one  of  the  windows  was  open,  and  yielded  17.2  parts 
of  carbonic  acid  in  10,000.  The  window  was  then  closed,  and  after  the 
lapse  of  ten  minutes  another  examination  gave  32.2  parts  of  carbonic  acid, 
or  an  increase  of  15.6  parts.  The  experiment  now  became  to  the  teacher 
and  children  so  oppressive  that  it  was  not  continued.  Dr.  Endemann 
says  :  '  If  the  accumulation  of  carbonic  acid  had  been  allowed  to  continue 
we  might  have  reached  within  one  hour  the  abominable  figure  of  no.' 


VENTILATION. 


The  following  is  a  statement  of  the  average  result  obtained  from  the 
several  experiments  made  in  each  school. 


As  expired  air  contains  not  only  this  poisonous  gas,  but  also  effete  animal 
matter  escaping  from  the  bodies  of  those  present,  and  in  quantities  in 
proportion  to  the  amount  of  carbonic  acid  exhaled,  and  it  follows  that  air 
vitiated  by  respiration  is  far  more  deleterious  than  air  vitiated  by  the  same 
amount  of  carbonic  acid  from  other  sources,  and  as  the  standard  of  per- 
missable  impurity  has  been  placed  by  high  sanitary  authority  (Dr.  Parkes 
and  others )  at  six  parts  of  carbonic  acid  in  10,000  of  air,  it  is  evident  that 
the  best  practical  talent  should  be  engaged  in  designing  and  perfecting 
means  for  securing  to  our  public  schools  adequate  and  thorough  ventilation. " 

I  recommend  the  Sanitary  Inspector  to  test  the  atmosphere 
of  some  of  our  first  class  hotels.  He  will  find  it  quite  as  car- 
bonic as  in  some  of  the  school-houses,  besides  being  redolent 
of  a  worse  miasm,  and  a  more  efficient  cause  of  dyspepsia  and 
consumption — tobacco  smoke. 

The  most  prevalent  error  in  private  houses  is  insufficient 
ventilation  of  the  bed -rooms.  Many  persons  who  take  great 
pains  to  have  pure  air  and  plenty  of  it  during  the  day,  will  take 
as  much  pains  to  exclude  it  during  the  night.  Many  a  dys- 
peptic is  fidgety,  nervous,  and  sleepless  half  of  the  night,  and 
irritable  and  melancholy  all  the  next  day,  simply  because  he 
had  been  told  by  somebody  that  "night  air  is  dangerous," 
and  had  excluded  it  from  his  room  as  much  as  possible.  Such 
persons  ought  to  be  informed  that  out-door  air  is  always  better 
and  never  worse  than  in-door  air. 

Young  children  and  infants,  though  born  with  fair  organiza- 
tions, are  often  rendered  puny  and  scrofulous  by  sleeping  in 
unventilated  rooms. 

Notwithstanding  the  many  "  physiologies  for  schools,"  the 
6cores  of  medical  journals,  the  lectures  and  writings  of  health- 
reformers,  and  the  wide  distribution  of  health  periodicals,  the 
ignorance  and  recklessness  of  the  great  majority  of  the  people 


Carbonic  Acid. 


Elm-street  School,  three  experiments  

Roosevelt -street  School,  two  experiments  , 

Thirteenth-street  (near  Sixth-avenue)  School,  two  experiments 


14.6 


Greenwich-street  School,  two  experiments. 
Vandewater-street  School,  two  experiments 
Madison-street  School,  four  experiments.  .  , 


142 


DYSPEPSIA. 


on  the  relation  of  respiration  to  health  is  astonishing.  Any 
one  may  have  a  demonstration  of  this  fact  any  cold  or  cool  day 
between  New  York  and  Philadelphia,  during  the  stave  season. 

A  few  days  ago  I  was  on  a  train  between  these  places.  The 
day  was  warm  and  sunny  ;  there  was  a  little  snow  on  the 
ground,  which  was  rapidly  melting.  In  the  car  were  two  stoves 
nearly  red-hot ;  nearly  every  seat  was  occupied,  not  one  window 
was  raised,  and  every  little  ventilator  overhead  was  closed  tight. 
The  air  soon  become  so  foul  that  I  was  actually  nauseated,  and 
several  of  the  passengers  were  nearly  asphyxiated — as  their 
semi-sleepy  appearance  and  stupid  dozing  but  too  plainly  in- 
dicated. Unable  to  get  a  seat  by  the  window,  I  occupied  my- 
self in  passing  from  one  car  to  another.  "  standing  on  the 
platform"  with  a  decided  disposition  to  trespass  on  the  "  rules 
and  regulations  "  every  time  I  changed  carsu  In  this  manner 
I  managed  to  ventilate  myself  until  a  seat  next  a  window  was 
vacated,  when  I  raised  the  window  and  ventilated  the  whole 
car.  Yet  in  this  car  were  full-grown  men  and  women,  well- 
dressed,  some  of  them  ornamented  with  jewelry  and  diamonds, 
and  all  of  them  appearing  intelligent  in  the  ways  of  business 
and  fashion.  Whose  fault  was  it  that  they  had  never  been 
taught  that  atmospheric  air  is  ' '  the  breath  of  life  "  ? 


CHAPTER  XXII. 
LIGHT. 

Bright  light  and  sunshine  are  among  the  remedial  in- 
fluences not  to  be  disregarded  in  the  management  of  dyspep- 
tic invalids.  The  congestion  of  the  large  internal  viscera,  the 
liver  especially,  disposes  them  to  melancholy  and  gloominess, 
which  condition  and  feelings  are  always  aggravated  by  dark  and 
shaded  apartments.  There  is,  moreover,  an  innervating  and 
inspiriting  influence  in  sunlight ;  hence  dyspeptics  should 
spend  as  much  time  as  possible  out  of  doors  in  clear  weather, 
only  avoiding  the  direct  rays  of  the  sun  when  they  are  painfully 
hot.    Window  curtains  should  be  eschewed,  even  though  the 


LIGHT. 


H3 


sunlight  fades  the  carpet ;  nor  should  dyspeptics  sit  in  parlors 
where  the  light  is  excluded,  however  luxuriously  furnished. 
Light  will  do  more  for  the  vitiated  blood,  morbid  secretions, 
and  neuralgic  nerves  than  glittering  mirrors  and  downy  sofas. 

It  is  well  known  to  physicians  that  the  people  who  reside  on 
the  sunny  side  of  the  streets  of  our  cities  are  less  liable  to  scrof- 
ula, zymotic  diseases,  and  cholera ;  and  that  underground 
apartments,  where  direct  sunlight  never  enters,  are  prolific 
sources  of  tubercular  affections  in  all  their  multitudinous  forms. 
Those  who9e  hard  fortune  compels  them  to  occupy  such  places 
are  almost  always  affected  with  measly  and  enlarged  livers,  and 
generally  also  with  tuberculosis  of  the  mesenteric  glands,  fre- 
quently extending  to  the  liver  and  lungs. 

Children  should  be  allowed  to  expose  their  heads  and  faces 
(and  the  whole  surface  frequently)  freely  to  sunshine  ;  if 
freckles  mar  the  beauty  of  the  girl,  it  will  be  amply  com- 
pensated by  the  fresher  complexion  and  superior  beauty  of  the 
woman.  Parasols,  except  in  the  middle  of  the  day  during  the 
"heated  term,"  are  pernicious  things,  as  are  the  veils  with 
which  so  many  fashionable  or  fashion-aping  ladies,  shade  their 
faces.  They  invariably  render  the  eyes  weak  and  irritable, 
aggravate  congestion  of  the  brain,  and  predispose  to  headache 
and  innumerable  indispositions  which  come  under  the  compre- 
hensive phrase,  4  4  nervousness. " 

There  is  much  food  for  reflection  in  the  following  paragraph, 
which  I  copy  from  the  Philadelphia  Evening  Star  : 

"  The  Sun  a  Physician.— Which  is  to  be  preferred,  a  faded  carpet  or  a 
faded  complexion  ?  Nine  tenths  of  our  lady  friends  will  say  a  "  faded  car- 
pet," and  yet  how  few  of  them  give  a  practical  expression  to  their  preference. 
If  some  of  the  pale-faced  women,  so  many  of  whom  are  seen  daily  in  the 
street,  could  be  prevailed  upon  to  make  up  their  minds  to  let  the  sunlight  of 
heaven  visit  them  more  frequently  and  more  liberally  m  their  dwellings,  they 
would  soon  find  that  the  bright,  rosy  colors  abstracted  from  the  carpets  would 
be  transferred  to  their  cheeks  again,  and,  more  than  this,  that  the  lassitude 
and  weariness  of  which  they  complain  would  be  replaced  by  the  freshness 
and  vigor  of  robust  health. 

"No  greater  mistake  can  be  made  than  that  of  excluding  the  sun  from 
the  dwelling.  The  sun  is  a  great  physician.  Its  curative  powers  are  not 
lufficiently  understood.    If  the  benefits  of  a  stm  bath  daily,  of  sun  in  the 


i44 


DYSPEPSIA. 


parlor,  the  sitting-room  and  the  bed-chamber  were  as  extensively  advertised 
as  are  some  of  the  quack  nostrums  of  the  day,  and  as  generally  patronized, 
how  many  more  bright  eyes  and  rosy  cheeks  we  should  see,  and  how  many 
less  pale-faced  invalids.    Give  Dr.  Sun  a  fair  trial. 


CHAPTER  XXIII. 

TEMPERATURE. 

Our  climate,  though  marked  temperate  on  the  maps,  is  very 
intemperate  in  its  vicissitudes,  the  thermometer  ranging  more 
than  i oo  degrees,  and,  in  some  years,  120  degrees  Fahr.  In 
summer  hundreds  die  of  "  sunstroke,"  and  in  winter  as  many 
die  of  extreme  cold.  Be.  this  mortality  is  much  more  attrib- 
utable to  invalidism,  or  to  unhygienic  habits  or  to  other  cir- 
cumstances, than  to  alternations  of  temperature.  Good  health 
can  be  enjoyed  whenever  good  digestion  can  be  performed. 
It  is  true  that  man  can  only  attain  his  highest  development 
within  certain  isothermal  lines  ;  for  the  relaxing  heat  of  the 
tropics  renders  him  indolent,  while  the  extreme  cold  regions 
make  it  impossible  for  him  to  do  much  more  than  provide 
necessary  food  and  shelter.  There  is,  however,  no  necessity 
for  dyspeptic  invalids  to  go  away  from  any  non-malarious  part 
of  the  United  Stales  in  order  to  recover  health,  provided  they 
make  the  proper  use  of  such  hygienic  measures  as  are  obtain- 
able in  all  healthful  localities.  Eastern  consumptives  have  a 
fashion  of  going  to  Minnesota  ;  but  as  they  generally  depend 
on  the  climate  there  to  effect  the  cure,  and  disregard  nearly 
all  other  conditions  of  health,  they  seldom  recover,  except  fiom 
the  incipient  stages  of  their  ailment.  And  northern  dyspeptics 
have  a  fashion  of  spending  their  winters  in  Florida,  the 
Bermudas,  or  some  other  place  where  milder  skies  prevail  in 
the  winter  season.  They  may  enjoy  themselves  better  in  "these 
places,  during  the  cold  months,  than  they  could  at  home,  as 
they  "live,  move,  and  have  their  being,"  more  in  the  open 
air,  and  may  prolong  life  ;  but  they  seldom  recover.  Dys- 
peptic, like  consumptive  invalids,  generally  carry  all  their  bad 


TEMPERATURE. 


H5 


habits  with  them,  trusting  to  the  "  one-ideaism  "  of  dimatopa- 
ihy ;  but  as  they  cannot  travel  away  from  themselves,  if  the) 
carry  their  maladies  and  the  causes  of  them  wherever  they  go, 
changes  of  place,  as  a  general  rule,  only  make  a  miserable 
life  more  tolerable,  and  perhaps  more  protracted.  Proper 
clothing,  suitable  dwellings  or  apartments,  and  hygienic  hab- 
its, render  it  possible  for  all  curable  dyspeptics  to  recover 
health  in  almost  any  latitude  or  locality  where  it  is  fit  for  a 
civilized  human  being  to  have  his  "  local  habitation  and  his 
name. " 

A  writer  in  the  Atlantic  Monthly  for  March,  1873  (George 
A.  Shone),  proposes  a  plan  for  superceding  Florida  and  the 
Antilles,  more  magnificent  and  praiseworthy  than  useful  or 
practical.  His  "  institution  "  contemplates  a  forty-acre  crystal 
palace,  so  arranged  with  steam-heaters  and  ice-reservoirs  that 
the  temperature  could  be  regular  to  any  degree  desired  ;  walks, 
fountains,  statuary,  flowers,  shrubbery,  etc. ,  are  to  make  the  in- 
side attractive,  while  boulevards,  parks,  play-grounds,  gardens, 
drives,  and  hotels  are  to  surround  the  immense  structure  of 
glass  and  iron.  The  cost  is  estimated  at  some  twelve  millions 
of  dollars,  and  the  income — two  dollars  a  day  for  board — at 
nearly  one  million.  The  financial  basis  is  well  arranged,  but 
who  would  be  benefited  by  it  ? 

It  would  be  patronized  mainly  by  the  idlers  who  would  go 
there  to  "kill  time,"  and  the  pleasure  seekers,  who  are  forever 
in  the  pursuit  of  new  sensations  under  difficulties  ;  and  there 
are  quite  too  many  attractive  places  of  resort  for  such  persons 
already. 

If  Mr.  Shone  supposes  that  dyspeptics  could  be  happy  in 
such  an  Eden,  it  is  because  he  has  not  had  many  of  them  to 
manage.  A  majority  of  them  would  find  the  ideal  paradise  a 
real  purgatory.  The  contrast  between  so  many  things  to  enjoy 
and  their  never-absent  but  ever-changing  aches  and  pains, 
would  aggravate  their  wretchedness,  transform  hypochondria 
to  madness,  and  doubt  to  despondency.  A  plain  cottage,  a 
rough  road,  a  sylvan  grove,  a  natural  river  or  stream,  and 
society  among  farmers  or  mechanics  who  pursue  some  useful 


146 


DYSPEPSIA. 


vocation,  and  whose  habits,  dress,  style  and  associations  are 
more  in  accordance  with  the  order  and  simplicity  of  nature,  is 
what  they  need.  When  some  intelligent  philanthropist  will 
arrange  a  forty-thousand-acre  farm  into  gardens,  and  orchards, 
and  workshops,  construct  plain  and  convenient  dwellings,  and 
provide  work  where  invalids  can  pay  their  way,  as  well  as  play 
grounds  for  recreation,  he  will  do  one  of  the  things  needful. 
It  is  the  poor  producers,  not  the  rich  consumers,  who  should  be 
the  study  of  the  world  s  charity  and  benevolence. 

CHAPTER  XXIV. 
MENTAL  rNTIiUENCES. 

Pleasant  scenery  and  cheerful  companions  are  certainly 
among  the  desiderata  for  dyspeptics.  They  must  have  exercise, 
and  whether  work  or  play  is  best,  when  only  one  is  available, 
depends  on  which  is  most  enjoyable  ;  for  exercise,  like  food, 
does  most  good  when  it  is  best  relished.  In  a  perfect  system 
of  exercise  for  invalids,  a  variety  of  work,  and  different  plays, 
would  be  embraced  in  the  remedial  programme.  All  work 
and  no  amusement  begets  stupidity  and  adds  to  melancholy ; 
while  all  play  and  no  useful  work  degenerates  into  selfishness 
and  dissipation.  The  wise  man  and  skilful  physician  will  com- 
bine the  two  in  such  manner  as  to  suit  the  various  conditions 
of  the  patients. 

Many  games  are  amusing,  and  so  far  useful ;  and  these 
should  be  varied  so  that  some  should  be  intellectual,  others 
social,  and  others  physical.  Dyspeptics  are  ever  prone  to  dwell 
on  their  morbid  sensations,  and  seem  never  to  be  so  miserably 
happy  as  when  relating  the  endless  story  of  their  sufferings  to 
others,  and  especially  to  the  physician.  They  should  be  led 
into  other  habits  and  out  of  this  one  ;  for,  unless  the  confirmed 
dyspepil  t  can  be  induced  to  think  little  and  talk  less  of  his  bad 
feelings,  the  chance  of  ultimate  recovery  is  small. 

There  is  a  wide  field  for  the  exercise  of  discretion  on  the 
part  of  the  medical  adviser  in  managing  dyspeptics  ;  and  the 


MENTAL  INFLUENCES. 


H7 


chief  point  of  skill  is  to  guide  hia  intercourse  with  them  so  as 
to  avoid  depressing  seriousness  and  irritating  levity.  His  man- 
ner should  always  be  positive  and  hopeful,  without  being  dog- 
matic or  flattering.  There  are  no  more  suspicious  persons  un- 
der the  sun  than  dyspeptics  who  feel  themselves  running  down 
in  spite  of  all  the  most  nutritious  food  their  weak  stomachs  can 
tolerate.  If  you  look,  talk  and  act  with  dignity  and  gravity, 
they  imagine  your  prognosis  is  unfavorable  ;  while  if  you  treafc 
their  symptoms  lightly,  or  do  not  give  sufficient  attention  to 
their  manifold  distresses,  and  cannot  satisfactorily  explain  all 
of  their  morbid  sensations  and  utterly  inexplicable  nervousnesses, 
they  are  apt  to  think  your  diagnosis  is  at  fault,  or  that  you  do 
not  take  proper  interest  in  their  case. 

The  Hygienic  physician  (and  no  other  ought  ever  to  meddle 
with  a  confirmed  dyspeptic),  should  give  the  patient  one  tho- 
rough examination  ;  listen  with  patience  (if  it  has  to  be  as- 
sumed for  the  occasion)  to  all  he  has  to  say,  relevant  or  irrele- 
vant ;  explain  the  nature  of  his  case  ;  indicate  its  complications 
and  their  special  causes  ;  give  him  the  rationale  of  his  leading 
symptoms ;  tell  him  the  plan  of  treatment  to  be  pursued,  and 
then  instruct  him  to  dismiss  all  thoughts  of  his  condition  and 
feelings,  save  when  they  are  manifestly  new  or  greatly  aggra- 
vated, and  give  his  whole  mind  and  might  to  doing  the  things 
which  make  up  the  remedial  plan. 

He  should  never  talk  nor  think,  if  he  can  help  it,  about  food 
while  he  is  eating  ;  but  take  the  quantity  and  quality  that  his 
judgment  approves,  and  say  to  the  stomach,  i(  Peace,  be  still." 

Nor  should  he  watch  his  sensations  after  meals,  to  see  how 
the  food  agrees,  for  this  is  almost  certain  to  make  it  disagree. 
* '  A  merry  heart  doeth  good  like  a  medicine."  Indeed  it  is 
medicinal  in  the  hygienic  and  best  sense  of  that  word  ;  and 
happy  is  the  physician,  and  blessed  is  the  pauent,  when  the 
judicious  manner  of  the  one,  and  the  cheerful  compliance  of 
the  other,  render  the  recovery  of  health  comparatively  easy. 

The  influence  of  imagination  on  the  vital  functions  has 
always  been  recognized  ;  and  it  was  this  recognition  that  enabled 
the  ancient  physicians  to  be  so  successful  with  charms,  amulets, 


148  DYSPEPSIA. 

and  incantations,  as  it  enables  thousands  of  persons  at  the  pre- 
sent day  to  perform  cures  which  seem  very  marvellous  to  those 
who  do  not  understand  the  rationale. 

Plato  taught  that  a  person  must  have  a  natural  disposition 
towards  a  thing  if  he  would  become  that  thing.  It  is  most 
true  that  where  the  disposition  dwells  on  an  imaginary  ailment, 
that  ailment  or  some  other  will  be  the  result  of  the  mental  in- 
fluence ;  and  true  also,  of  the  opposite  mental  state,  when  the 
mind  dwells  on  anticipated  health  the  doctor  has  much  less  to 
do. 

We  should  not  be  too  hard  on  the  quacks  so  long  as  the 
people  ' ' will  have  medicine."  True,  the  medical  profession 
ought  to  teach  them  the  better  way  ;  but  as  they  do  not, 
as  invalids  must  have  something  to  pin  their  faith  to  besides 
reason  and  common  sense,  and  as  the  empirics  are  quite  as 
safe  as  the  regulars  in  their  manner  of  dosing  and  materia 
medica,  it  would  be  a  calamity  to  suppress  them  if  we  could, 
unless  we  could  at  the  same  time  suppress  the  materia  medica 
of  the  regular  profession. 

Lord  Bacon  has  said:  ''The  imagination  is  next  akin  to 
miracle-working  faith;"  and  that  "It  needeth  a  Delian  diver 
rightly  to  pursue  the  study  of  the  imagination  in  disease." 
Edward  Spencer,  in  the  Atlantic,  in  an  article  entitled  "A  good 
word  for  Quacks, "  remarks  : 

€t  There  is  no  doctor  who  would  not  rather  contend  with  serious  and  even 
vital  maladies,  than  with  the  thousand  and  one  conceits  and  hypochondriacal 
fancies  of  the  malade  imaginaire,  who,  aggrieved  by  dyspepsia,  and  with 
his  mind  all  awry,  demands  to  be  treated  for  every  disease  under  heaven 
but  the  one  mental  lesion  that  makes  him  such  a  thorough  nuisance.  He 
has,  indeed,  no  mortal  malady  ;  but  does  not  his  imag  naticn  give  such  as 
real  and  actual  a  twist  to  the  nervous  currents  of  his  body  as  the  magnet 
gives  to  the  course  of  the  compass  ?  It  is  a  nervous  condition  like  this — 
and  all  sickness  is  accompanied  with  more  or  less  general  disturbance  of  the 
nerves  —that  the  doctor  and  the  quack  equally  find  their  opportunity,  and 
establish  their  prestige,  by  working  upon  the  excited  and  despondent  or 
expectant  feelings.  The  force  of  sympathy,  even,  can  work  a  miracle,  if 
the  mind  be  in  this  state." 


OCCUPATION. 


H9 


CHAPTER  XXV. 
OCCUPATION. 

Useful,  and,  in  many  cases  indispensable  as  may  be  the 
remedial  measures  treated  of  in  the  preceding  chapters,  there 
are  many  cases  of  invalidism  in  which  occupation  is  the  one 
thing  needful.  There  are  three  classes  of  society,  considered 
in  reference  to  health,  the  working  class  proper,  who  have  reg- 
ular vocations,  but  who  can  have  needful  leisure  for  recreation 
and  education^-the  middle  class  ;  the  drudging  class,  who  are 
i  toiled  to  death  like  beasts  of  burden  prematurely,  and  the  idle 
class.  I  need  hardly  say  that  the  last  two  classes  are  abnormal- 
ities in  sociology  ;  and  it  is  difficult  to  say  which  is  most  to 
be  pitied.  It  is  hard  to  labor  incessantly  with  no  reward  ex- 
cept just  food,  and  raiment,  and  shelter  enough  to  keep  the 
muscles  in  working  order  ;  no  opportunity  for  mental  improve- 
ment, and  no  hope  of  a  better  future  in  this  life  ;  and  this  is 
the  condition  of  more  than  one-half  of  the  human  race.  But 
who  knows  the  miseries  of  "upper  tendom?"  I  am  of  the 
opinion  that  to  rust  and  rot  to  death,  or  to  die  of  dissipation, 
is  quite  as  disagreeable,  all  things  considered,  as  to  be  worked 
to  death.  The  hopeless  pauper  may  have  few  enjoyments  ;  but 
the  great  law  of  compensation  does  not  make  an  exception  in 
his  case  ;  he  is  exempt  from  a  thousand  miseries  that  those  who 
only  live  to  eat,  drink,  dress,  and  enjoy  the  fruits  of  others' 
labors,  suffer  continually.  Indeed,  one  can  hardly  walk 
through  the  thoroughfares  of  the  world's  great  cities,  and  wit- 
ness the  meretricious  displays  of  what  is  called  wealth  and 
fashion,  without  a  thought,  if  he  is  reflective,  that  one  class  of 
our  people  make  themselves  miserable  in  order  to  have  other 
classes  think  that  they  are  happy.  There  are  thousands  of 
beggars  who  would  not  exchange  their  "  home"  in  some  sti- 
fling attic,  for  palatial  mansions,  provided  they  were  obliged  to 
take  the  vexations,  cares,  sickness,  doctors,  nurses,  and  their 
attendant  and  inseparable  disappointments. 


15° 


DYSPEPSM. 


Invalids  should  have  some  occupation  that  is  useful,  and 
some  object  in  life  ;  for  it  is  the  thing  to  be  achieved  in  the 
distant  though  uncertain  future  that  energizes  the  mind,  invig- 
orates the  body,  gives  persistence  to  effort,  overcomes  obstacles, 
and  keeps  mind  and  body  in  harmonious  relations  to  each 
other. 

God  and  nature  have  so  ordered  the  universe  that  one  person 
can  no  more  do  another's  work,  without  damage  to  both  than 
one  can  do  another's  eating,  or  sleeping,  or  breathing. 

As  dyspeptics  are  more  prone  to  depression  and  melan- 
choly than  most  other  clasGes  of  invalids,  whatever  can  inspire 
hopefulness  should  be  made  available,  if  possible.  And,  valu- 
able as  are  gymnasia,  games,  plays,  etc.,  there  are  many  cases 
in  which  all  together  do  not  equal  in  remedial  efficacy,  any  use- 
ful and  healthful  occupation  I  have  many  times  wondered 
that,  with  so  much  surplus  wealth  in  the  land,  and  so  much 
benevolence  seeking  expression  and  practical  application,  not  a 
single  dollar  was  ever  given  for  such  an  institution  as  human 
society  needs  more  than  all  others — an  institution  to  provide 
health  conditions,  employment,  and  hygienic  education  and 
training  for  the  sick  and  needy. 

Much  is  said,  now- a  days,  of  persons  dying  of  overwork. 
But  there  was  never  a  greater  error.  The  Golden  Age,  in  a 
recent  issue,  talked  the  right  sentiments  on  this  subject : 

"  The  newspapers  never  tire  of  preaching  pleasant  homilies  on  overwork. 
Gov.  Geary  died  of  that  disease.  3o  did  Mr.  Greeley.  And  so  did  Mr. 
Raymond.  And  so  do  hundreds  of  other  men  whose  work  the  world  wants, 
and  whose  wisdom  and  experience  arc  sorely  needed.  We  have  committed 
the  homily  to  memory,  and  can  produce  it  with  variations  and  illustrations 
whenever  circumstances  require  us  to  talk  without  saying  anything.  But  the 
plain  truth  is  that  not  one  man  in  a  million  dies  from  overwork  alone.  It 
is  not  the  overwork,  but  working  in  unwise  ways,  without  that  care  of  vital 
mechanism  which  is  absolutely  necessary  to  keep  it  from  wearing  out  at  one 
point  or  breaking  down  at  another,  which  does  the  mischief  we  so  loudly 
deplore.  One  man  kills  himself  by  brain -work,  because  he  is  too  indolent 
or  stupid  to  balance  the  account  by  a  proper  amount  of  muscular  exercise. 
Another  kills  himself  by  irregular  habits,  or  exposures,  or  strains,  or  over- 
indulgence. Sometimes  a  working  man  steals  an  hour  or  two  away  from 
sleep  every  night,  and  is  put  to  death  for  petit  larceny.    Sometimes  a  man 


OCCUPATION. 


dies  because  the  sober  cares  of  life  have  completely  choked  the  laughter- 
valve  of  his  nature  and  ten  perish  from  excess  of  worry  where  one  dies  from 
excess  of  work. 

"  The  example  ot  Talleyrand,  Napoleon,  Brougham,  Humboldt,  not  to 
mention  other  eminent  toilers,  goes  to  show  that  there  is  scarcely  any  limit 
to  the  amount  of  labor  a  man  can  do,  provided  that  he  will  keep  himself  at 
the  highest  working  condition,  and  use  himself  with  the  same  wisdom  and 
care  with  which  he  manages  a  valuable  horse  or  a  finely-constructed  machine. 
If  he  will  insist  on  compelling  the  animal  he  is  bound  up  with  to  do  two  days' 
work  in  one  day,  or  to  strain  himself  by  some  terrible  over-exertion,  or  to 
tug  and  toil  in  the  harness  until  every  particle  of  elasticity  is  lost  and  the 
possibility  of  recuperation  is  gone — if  he  will  neglect  the  fine  and  delicate 
mechanism  until  friction  wears  it  out  in  one  place  and  rust  eats  it  out  in 
another,  and  dust  clogs  its  joints  and  cinders  cut  through  its  nicely  adjusted 
gearing — he  must  pay  the  penalty  of  his  neglect  in  impaired  power  and  a 
premature  breaking  down.  It  is  not  less  labor  that  men  want,  but  wiser 
methods  of  working,  more  varied  occupation,  better  care,  more  frequent 
recuperation,  and  larger  invoices  of  mirth  and  joy,  with  nobler  incentives 
and  hopes.  We  are  satisfied  that  had  Mr.  Greeley  given  half  the  thought 
to  caring  for  himself  that  he  gave  to  the  care  of  cattle,  had  he  balanced  his 
exacting  brain-work  with  a  corresponding  physical  exercise,  if  he  had  taken 
a  daily  bath  of  side-shaking  and  soul-expanding  laughter,  if  instead  of  keep- 
ing one  set  of  faculties  pressed  down  upon  the  grindstone  until  they  were 
ground  clean  away  he  had  given  each  set  its  turn,  he  would  doubtless  have 
done  more  and  better  work  and  been  alive  to-day.  And  so  of  the  other 
men  whose  premature  departure  is  usually  attributed  to  the  same  cause. 
It  is  not  overwork  but  unwise  working  that  kills.  It  is  not  less  labor,  but 
larger  and  wiser  living  that  is  needed  to  prolong  life  and  enhance  its  results  ' ' 

On  this  overwritten  subject  of  overwork,  a  late  issue  of  the 
Saturday  Review  has  some  pertinent  remarks  : 

"Overwork  is  sometimes  a  simple  appeal  for  compassion  ;  its  supposed 
victim  is  merely  acting  the  part  of  pallid  student,  to  impress  the  audience  at 
home.  More  frequently  it  is  a  delicate  periphrasis  for  other  evils  of  a  less 
presentable  nature.  Its  sufferer  may  be  imputing  to  intellectual  exertion 
what  is  really  due  to  a  misguided  passion  for  supper-parties  and  to  nights 
spent  in  devotion  to  loo.  In  short,  overwork  is  a  highly  convenient  veil  to 
throw  over  the  innumerable  methods  in  which  a  youth  may  injure  his  con- 
stitution. If  the  physical  mischief  produced  by  excessive  study  could  be 
fairly  compared  with  the  mischiefs  produced  by  other  causes,  we  have  a 
shrewd  suspicion  that  their  sum  total  would  be  infinitely  less  than  is  gener- 
ally supposed.  We  may  say  pretty  confidently,  from  a  tolerably  wider 
experience,  that  the  number  of  victims  to  overwork  is  utterly  insignificant 


I52 


DYSPEPSIA. 


compared  with  the  number  of  victims  from  other  causes,  and  with  the  num- 
ber of  cases  in  which  the  excuse  is  imposed  upon  soft-hearted  relations. 

"  Business  which  keeps  a  man  in  a  constant  oscillation  between  ruin  and 
a  fortune,  which  follows  him  home  and  prevents  him  from  sleeping,  is  incom- 
parably more  trying  than  almost  any  quantity  of  downright  steady  work. 
The  Stock  Exchange,  at  New  York,  must  fill  lunatic  asylums  more  quickly 
than  all  the  most  laborious  Universities  in  Germany,  England,  and  Amer- 
ica. A  professor  may  labor  at  the  collation  of  manuscripts,  or  even  at  the 
search  for  the  absolute,  for  fifteen  hours  a  day,  and  be  all  the  better  for  it  ; 
a  third  of  the  time  spent  in  studying  the  ups  and  downs  of  Erie  Railroad 
shares,  and  staking  money  on  the  result,  would  qualify  him  for  a  strait - 
waiscoat  or  a  halter  in  a  year.  As,  however,,  speculation  has  a  compara- 
tively discreditable  sound,  the  evils  which  it  produces  are  very  frequently 
placed  to  the  account  of  its  more  respectable  rival,  straightforward  indus- 
try. We  choose,  in  one  form  or  another,  to  spend  a  great  part  of  our  time 
at  the  gaming-tables  which  exist  in  an  infinite  variety  of  forms  in  every 
capital  in  the  world,  and  then  complacently  complain  that  we  have  injured 
ourselves  by  over  application  to  our  duties. 

'•  As  a  rule,  therefore,  we  should  say  that  the  complaints  of  overwork 
are  amongst  the  most  flimsy  of  all  the  excuses  set  up  by  men  for  the  evils 
which  they  bring  upon  themselves.  Very  few  people  really  work  hard  ; 
and  when  they  do  it  generally  agrees  with  them.  Directly  or  indirectly 
idleness  does  fifty  times  as  much  mischief,  for  the  best  cure  for  the  love  of 
excitement  is  steady  application.  A  vast  amount  of  good  pity  is  thrown 
away  in  the  world,  and,  instead  of  solemnly  warning  our  friends  not  to  do 
too  much,  we  should  find  it  simpler  to  refuse  the  indirect  compliment  for 
which  they  are  maneuvering,  and  advise  them  to  relax  their  minds  by  a 
little  strenuous  activity.' ' 

Another  very  prevalent  error  is  the  notion  that  intellectual 
vigor  and  a  pleasurable  life  are  incompatible  with  the  declin- 
ing period  of  life,  or  old  age.  The  world  is  full  of  examples 
to  the  contrary,  and  all  periods  of  history  record  them.  Cor- 
naro  became  a  broken  down  dyspeptic  at  forty  ;  but  by  adopt- 
ing a  " sober  and  temperate  life,"  enjoyed  good  health  till 
nearly  one  hundred. 

It  is  said  of  Arnauld,  the  Jansenist,  that  he  wished  his  friend 
Nicole  to  assist  him  in  a  new  work.  Nicole  replied  :  "We 
are  now  old;  is  it  not  time  to  rest?"  "Rest,"  exclaimed 
Arnauld,  "have  we  not  all  eternity  to  rest  in?" 

Dr.  Samuel  Miller  says:  "There  is  no  doubt  that  the  pre- 
mature dotage  of  many  distinguished  men  has  risen  from  their 


OCCUPATION. 


153 


ceasing,  in  advanced  life,  to  exert  their  faculties,  under  the 
impression  that  they  were  too  old  to  engage  in  any  new  enter- 
prise/' 

When  John  Adams  was  90  years  of  age  he  was  asked  how 
he  kept  the  vigor  of  his  faculties  up  to  that  great  age.  He  re- 
plied :  "By  constantly  employing  them;  the  mind  of  an  old 
man  is  like  an  old  horse  ;  if  you  would  get  any  work  out  of  it 
you  must  work  it  all  the  time.  ' 

We  have  on  record  many  remarkable  instances  of  earnest 
and  successful  workers  after  they  have  passed  into  the  period 
known  as  old  age. 

Ecclesiastical  history  tells  the  story  of  Casidorus,  who  at  the 
age  of  70  retired  to  a  monastery  and  devoted  the  remaining 
twenty  years  of  his  life  to  literature  and  religion ;  and  of  Epi- 
phanius,  who  became  an  author  at  64  and  wrote  several  large 
works  before  his  death. 

Between  the  ages  of  58  and  67  Baxter  wrote  forty  works  ; 
after  the  age  of  66  some  of  his  most  valuable  works  were  writ- 
ten. 

1 '  The  only  remarkable  thing, "  says  Hannah  Moore,  ' '  which 
belonged  to  me  as  an  authoress,  was  that  I  had  written  eleven 
books  after  the  age  of  sixty. " 

Says  Lord  Brougham,  at  the  conclusion  of  his  autobiography  : 
"  If  any  statements  have  been  feebly  and  inaccurately  rendered, 
it  may  be  remembered  that  I  began  this  attempt  after  I  was 
eighty-three  years  of  age,  with  enfeebled  health,  failing  mem- 
ory, and  but  slight  materials  by  me  to  assist  it. 

Plato  died  at  the  age  of  eighty-one,  it  is  said,  with  pen  in 
hand  ;  and  an  account  is  given  of  another  who  wrote  a  history 
of  his  time  at  the  age  of  one  hundred  and  fifteen. 

William  Cullen  Byrant  is  a  living  example  of  mental  and 
physical  vigor,  at  nearly  threescore  and  ten,  equal  to  the  best 
days  of  early  manhood,  because  of  a  sober  and  temperate  life, 
and  due  attention  to  vital  conditions  while  performing  im- 
mense mental  labor. 

Mrs.  Sarah  J.  Hale,  now  eighty-five,  is  as  entertaining  (and 
more  instructive)  with  her  busy  pen,  as  she  was  fifty  years  ago. 


154 


DYSPEPSIA. 


It  would  not  be  difficult  to  name  a  hundred  living  persons 
of  distinction  who  illustrate  the  principle  that  long  life  is  con- 
sistent with  great  mental  activity,  and  also  with  active  and 
constant  manual  labor.  But  the  final  conclusion  of  the  whole 
matter  may  be  summed  up  in  these  words  :  Hard  workers 
oflen  live  to  be  old ;  idlers,  seldom. 

In  conclusion,  I  will  add  the  testimony  of  my  own  personal 
experience  ;  which  is  this.  Thirty  years  ago  I  adopted  the 
mode  of  life  recommended  in  this  work  ;  and,  although  I  have 
often  felt  obliged  to  labor  inordinately,  and  have  done  much 
literary  night-work,  I  have  not,  during  the  last  thirty  years, 
lost  one  day's  work  because  of  physical  inability  to  do  it,  and 
have  not  at  any  time  been  in  a  mental  condition  that  obliged 
me  to  decline  literary  work,  when  I  have  had  time  and  oppor- 
tunity to  do  it. 


APPENDIX. 


The  following  article,  written  by  request  for  a  newspaper, 
which,  however,  refused  to  publish  it  because  of  its  "  radical- 
isms," is  appended  to  this  work,  as  being  a  true  exposition  of 
the  case  of  Mr.  Greeley,  and  as  applicable  to  many  similar  cases 
which  are  continually  occurring.  The  writer  is  morally  certain 
that  many  valuable  lives  have  been  and  may  be  saved,  by 
adopting  the  plan  of  treatment  which  is  mentioned  as  applicable 
to  the  case  of  Mr.  Greeley. 

DEATH  OF  HORACE  GREELEY. 

BY  R.  T.  TRALL,  M.D. 

"  Let  us  have  peace  "  in  the  dying  hour.  When  the  would-be  assassin 
of  the  late  Governor  Seward  was  called  on  to  "  report "  himself  at  the 
gallows,  and  "be  hung  by  the  neck  until  he  was  dead, "  he  was  offered  the 
customary  brandy  to  support  him  through  the  terrible  ordeal.  "No,"  re- 
plied the  condemned  malefactor,  "I  intend  to  die  sober." 

It  is  a  horrible  reflection  on  a  false  medical  system,  which  mistakes  the 
fever  of  stimulation  for  vital  invigoration,  that  so  few  men  of  prominence  in 
society  are  permitted  to  die  in  their  "right  mind."  They  are  plied  with 
stupefying  narcotics,  or  delirium-inducing  stimulants,  until  the  brain  reels 
and  the  recognitions  become  illusive,  and  finally,  "the  emancipated  souls 
ascend  to  the  bosom  of  their  God  "  in  a  state  of  gibbering  intoxication,  or 
"dead"  drunkenness. 

We  rarely  read  of  the  medical  treatment  of  any  distinguished  person, 
without  brandy  and  morphine,  or  their  equivalents,  being  among  the  lead- 
ing remedies.  Precisely  how  this  was  with  the  late  Horace  Greeley  we 
seem  not  likely  to  know,  except  inferentially,  as  the  physicians  who  know 
the  most  about  the  matter,  positively  refuse  to  give  any  information  except 
in  vague  generalities.  Perhaps  the  people  have  no  rights  in  this  affair 
which  the  medical  profession  is  bound  to  respect.    But,  it  concerns  the 


i56 


APPENDIX. 


living  to  know  how  Mr.  Greeley  was  treated,  and  why  he  died.  Can  any 
one's  life  be  safe  if  the  doings  of  the  doctors  must  be  shrouded  in  mystery  ? 
If  the  treatment  of  any  given  case  will  bear  criticism,  what  have  the  doctors 
to  fear?  If  it  will  not,  the  people  ought  to  know  why.  Is  not  the  suspi- 
cion legitimate  that  Mr.  Greeley's  physicians  dare  not  submit  their  medica- 
tion to  public  judgment  ?  It  may  be  argued  that  non  professional  persons 
are  not  proper  judges.  Granted  ;  but,  cannot  the  learned  physicians  explain 
and  defend  ? 

I  think  it  is  not  difficult  to  show  that  all  of  the  professional  opinions 
which  were  given  of  Mr.  Greeley's  disease  were  erroneous,  and  that  all  of 
the  medication,  so  far  as  it  has  been  published,  was  worse  than  useless.  In 
making  this  sweeping  statement  I  wish  it  distinctly  understood  that  I  bring 
no  charge  against  the  integrity  nor  intelligence  of  his  physicians.  I  im- 
peach the  system,  not  the  men.  That  being  false,  the  treatment  could  not 
have  been  true  ;  for  physicians,  like  other  persons,  must  practice  according 
to  their  theories. 

With  regard  to  the  diagnosis,  we  have  five  or  six  opinions  from  as  many 
physicians:  ''acute  mania,"  "inflammation  of  the  brain,"  "paralysis  of 
the  brain,"  "  hemiplegia,"  and  "  organic  disease  of  the  brain."  The  most 
eminent  of  the  physicians  who  were  called  in  consultation,  were  as  contra- 
dictory in  their  opinions  as  they  were  celebrated  for  skill  in  just  such  cases  / 
But,  the  history  of  the  patient,  and  the  causes  and  symptoms  of  the  "  ner- 
vous prostration  "  which  all  agreed  was  the  essential  condition,  do  not 
justify  any  one  of  the  diagnoses.  That  Mr.  Greeley  had  been  excessively 
worked,  and  needed  quiet,  rest,  sleep,  is  plain  enough  ;  and  this  was  the 
whole  case.  But,  as  he  did  not  incline  to  sleep,  he  was  drugged  to  stupe- 
faction, and  therein  was  the  fatal  mistake.  It  was  this  first  drugging  that 
induced  the  subsequent  alarming  symptoms  which  so  confounded  the  diag- 
nosis of  the  physicians. 

Nearly  a  year  ago,  the  Prince  of  Wales  was  supposed  to  be  dying.  For 
several  days  he  lay,  as  was  supposed,  at  the  point  of  death  at  Sandnngham  ; 
and  he  was  only  saved  by  an  incident  which  does  not  often  happen  under 
such  circumstances— the  discontinuance  of  the  medicine.  So  long  as  the 
doses  were  swallowed,  the  symptoms  continued  alarming,  and  the  accu- 
mulated doses  finally  occasioned  so  much  "nervous  prostration,"  that  his 
four  attending  physicians,  mistaking  the  effects  of  the  medication  for  fatal 
complications,  diagnosticated  "goneness  of  one  lung,"  and  " perforation  of 
the  bowels."  Had  the  illustrious  patient  been  a  politician  instead  of  a 
prince,  the  doctors  would  probably  have  sought  for  {he  diagnoses  in  the 
head  instead  of  the  vitals,  and  doubtless  have  discovered  as  many  impossi- 
ble things  as  were  ascertained  in  the  case  of  Mr.  Greeley.  But,  fortunately 
for  the  Prince,  Dr.  Gull  was  called  in  consultation,  and  the  treatment 
opportunely  changed  from  "brandy  and  other  stimulants,"  to  milk.  And 
the  milk  "acted"  marvellously!    In  a  few  hours  thereafter  the  patient 


157 


was  convalescent,  and  in  twenty -four  hours  was  out  of  all  danger.  There; 
are  two  theories  extant  in  relation  to  this  wonderful  change.  I  shall  only 
state  them  and  leave  the  reader  to  his  inferences.  One  is  that  milk,  under 
certain  peculiar  and  extraordinary  circumstances,  is  a  medicine  of  peculiar 
and  extraordinary  virtues  ;  and  the  other  is  that,  as  soon  as  the  patient  had 
eliminated  the  drug  medicines  he  began  to  recover.  Those  who  adopt  the 
latter  theory  say  that  the  patient  was  never  in  any  danger,  except  of  being 
drugged  to  death,  as  was  his  father  in  1862. 

Humanity  is  naturally  tough.  Human  beings  do  not  die  of  over- 
worked brains,  want  of  sleep,  fatigue,  or  "nervous  prostration."  And 
Mr.  Greeley  was  perhaps  the  last  man  in  all  this  nation  to  be  senously  dis- 
eased, much  less  to  die  because  of  political  disappointment,  domestic  afflic- 
tion, losses  of  property,  position,  or  friends.  He  was  "  a  man  of  sorrows 
and  acquainted  with  grief,"  as  all  true  reformers  and  real  philanthropists  are. 
His  great  good  heart,  and  mighty  though  sometimes  erring  head,  were 
accustomed  to  pecuniary  disasters,  to  bereavements  that  rive  the  soul,  and 
he  was  familiar  with  both  victories  and  defeats  in  moral,  political,  and  social 
conflicts.  Few  men  ever  had  a  bet tet  preparatory  education  for  all  possible 
vicissitudes  of  fortune,  and  none  ever  more  clearly  realized  or  complacently 
contemplated  the  uncertainties  of  political  controversies.  That  he  worked 
hard  for  and  earnestly  desired  to  attain  the  highest  position  of  honor  and 
influence  may  be  admitted.  But,  to  suppose  that  failure  maddened  or  in- 
flamed his  bram  and  demoralized  his  whole  nature,  is  simply  absurd.  He 
was  fully  aware  of  all  that  could  possibly  happen  in  the  immediate  future, 
and  fully  prepared  for  it.  To  talk  of  Horace  Greeley  dying  of  presidency 
on  the  brain,"  though  he  might  have  been  mistaken  or  unwise,  or  sicken- 
ing unto  death  because  of  the  death  of  his  wife — who  had  been  dying  of 
consumption  for  several  years— is  a  libel  on  his  name  and  fame.  And  add 
to  these  afflictions  severe  toil,  night -watching,  and  the  vexations  of  injudi- 
cious friends,  selfish  employees,  and  knavish  and  hypocritical  associates,  and 
still  Horace  Greeley  was  man  enough  to  have  endured  the  whole  without 
dying. 

The  elephant,  whose  prowess  fears  not  all  the  animals  of  the  forest,  may 
be  destroyed  by  an  infinitesimal  insect.  A  man  of  powerful  body  and  giant 
mind  may  die  of  a  single  grain  of  poison  or  of  medicine.  If  Horace  Greeley, 
after  the  presidential  campaign  was  decided,  and  his  wife's  remains  had  been, 
deposited  in  the  4 'city  of  the  dead,"  could  have  had  undisturbed  quiet  for 
a  few  days,  he  would,  in  all  human  probability,  before  this  time  have  re- 
sumed his  proper  place  and  sphere  as  editor  of  the  Tribune. 

The  effects  of  prolonged  watchfulness,  excessive  labor  of  body  and  mind, 
disappointed  ambition,  and  personal  grievances  (and  these  are  all  the  ele- 
ments of  the  case),  are,  accumulation  of  blood  in  the  brain,  constituting 
cerebral  congestion,  and  deficiency  of  blood  in  the  surface  and  extremities. 
This  general  condition  of  unbalanced  circulation  is  evinced  by  hot  head  or 


i58 


APPENDIX. 


pain  in  the  head, with  cold  feet,  rendering  the  patient  sleepless,  irritable,  and 
semi-delirious.  A  little  aggravation  of  this  congestion  would  render  the 
patient  apoplectic;  but  there  is  nothing  in  this  condition  or  in  the  attend- 
ing symptoms,  taken  as  a  whole,  on  which  to  predicate  "mania,"  inflam- 
mation," or  44  paralysis."  Dyspeptics  very  frequently  have  a  similar  con- 
dition, with  every  one  of  Mr.  Greeley's  symptoms,  for  months,  and  yet  recov- 
er. It  is  not  unfrequent  for  dyspeptics  who  are  not  seriously,  certainly  not 
dangerously  sick,  to  sleep  so  little  and  so  fitfully  that  they  imagine  they  do 
not  sleep  at  all. 

The  medication  that  Mr.  Greeley  needed  was  simply  hygienic.  I  think 
any  competent  nurse,  left  to  his  or  her  wits,  without  the  aid  or  interference 
of  physicians,  would  have  cured  the  patient.  If  he  had  been  left  to  him- 
self, and  all  visitors  kept  away,  he  would  in  due  time  have  slept  from  shear 
exhaustion,  as  patients  do  after  a  severe  fever.  And  the  sleep  would  have 
saved  him,  as  it  does  them,  when  they  are  not  annoyed  by  attendants.  This 
is  nature's  method  of  balancing  the  circulation  and  restoring  "the  normal 
play  of  all  the  functions."  It  is  a  mistaken  pathology  that  is  always  seek- 
ing the  cause  of  deranged  vital  functions  in  paralysis  or  other  affections  of 
the  brain.  The  brain  is  the  most  vitalized  structure  of  the  whole  system, 
and  cannot  be  paralyzed. 

The  following  plan  of  treatment  would  have  been  proper  for  Mr.  Greeley, 
and  has  been  invariably  successful  in  similar  cases,  in  the  hands  of  Hygienic 
physicians  :  He  should  have  had  a  warm  bath,  just  prolonged  enough  to 
bring  the  blood  well  to  the  surface,  and  then  put  to  bed  in  a  quiet,  well- 
lighted  and  well-ventilated  room,  of  an  even  and  agreeable  temperature. 
His  feet  should  have  been  kept  constantly  warm  with  bottles  of  hot  water, 
bags  of  sand,  heated  bricks,  or  something  similar.  So  long  as  the  head  was 
hot  and  painful  a  cool  wet  cloth  should  have  been  applied  to  the  forehead 
and  face,  covering  the  eyes  so  as  to  favor  sleep.  If  the  head  was  affected 
at  any  time  with  neuralgic  or  intermitting  pains,  without  heat,  warm  wet 
cloths  (fomentations)  should  have  been  applied  until  relief  was  obtained, 
and  then  the  cool  wet  cloth  resumed.  All  visitors  should  have  been  excluded. 
Nothing  is  more  pernicious  in  such  cases  than  meddlesome  attentions, 
the  constant  calls  of  friends  and  neighbors,  frequent  interviewings  of  report- 
ers, constant  quizzing  of  curiosity -seekers,  and  perpetual  examinations  of 
physicians  in  watching  the  ever-changing  phases  of  the  multitudinous 
diagnoses.  Mr.  Greeley  had  enough  of  these  annoyances  to  account  for  the 
M  taking  off,"  to  say  nothing  of  the  abominable  drugging.  He  should  not 
have  had  but  a  single  watcher,  lest  whispering  might  disturb  him,  and 
even  that  watcher  should  have  occupied  an  adjacent  apartment— never  the 
same  room  ;  for  in  such  cases  of  "  extreme  nervous  prostration,"  the  mere 
presence  of  another  in  the  room  may  prevent  the  all-important  sleep. 

How  different  was  the  management  in  Mr.  Greeley's  case  !  The  physi- 
cians would  let  him  have  no  peace.    Friends  and  neighbors  were  annoying 


APPENDIX. 


159 


him  continually.  He  was  transported  "from  pillar  to  post  and  tested 
and  experimented  on  till  the  last  breath.  "Did  he  know  this  person?" 
"  Could  he  recognize  Mr.  Weed?"  Did  he  know  he  was  insane  ?  Was 
he  conscious  of  mania  or  paralysis  ?  The  two  latter  questions  were  proba- 
bly not  asked,  but  they  are  no  more  absurd  than  those  which  were  asked. 
No  wonder  the  tormented  sufferer  lost  all  power  of  normal  recognition,  and 
could  only  gibber  incoherent  phrases  as  one  does  in  delirium  tremens  :  "I 
died  when  I  was  born,  and  was  born  when  I  died."  Left  to  himself,  I 
repeat,  Horace  Greeley  would  have  slept  ;  and  if  his  sleeping  had  not  been 
disturbed,  as  it  should  not  have  been,  he  would  in  due  time  have  awakened, 
and  then,  if  his  vital  organs  had  been  so  exhausted  that  death  was  inevitable, 
he  would  have  entered  the  dark  valley  of  the  shadowy  land,  in  the  full 
possession  and  use  of  every  power  and  faculty  of  the  immortal  mind,  as  all 
persons  do  who  die  a  "  natural  death," 

The  doctors  did  indeed  recognize  the  maxim,  "sleep  or  death,"  as 
applicable  to  Mr.  Greeley's  case.  And  now  let  us  see  how  they  tried  to 
put  him  to  sleep.  Dr.  Krackowizer,  who  first  took  the  patient  in  hand,  gave 
him,  according  to  the  Philadelphia  Press,  "energetic"  treatment.  The 
New  York  Sun  of  Dec.  6,  tells  us  that  this  energetic  treatment  consisted  of 
thirty  grains  of  bromide  of  potassium  daily.  Verily  it  was  energetic.  Dr. 
Krackowizer  claims  that  this  was  a  moderate  dose.  Let  us  see  what  the 
highest  authority  {United States  Dispensatory,  page  1 152)  says  of  this  drug  : 
"  When  given  in  large  doses  (five  drachms  daily)  M.  Rames  found  it  to 
produce  a  peculiar  intoxication,  attended  with  torpor  and  drowsiness.  In 
one  case  this  condition  was  attended  by  an  insensibility  so  complete  that 
the  puncture  of  the  skin  with  a  suture  needle  was  not  felt,  and  the  titillation 
of  the  conjunctiva  and  fauces  with  a  feather  produced  neither  winking  nor 
a  desire  to  vomit." 

Dr.  Krackowizer  says  the  patient  was  more  quiet  for  several  hours  after 
taking  the  first  dose.  No  doubt.  But  it  was  the  quiet  of  apoplectic  stupor, 
instead  of  the  quiet  of  recuperating  sleep.  All  of  the  salts  of  potassium, 
(nitre,  tartar  emetic,  etc.)  are  among  the  most  debilitating  agents  of  the 
materia  medica.  A  few  grains  too  many,  administered  in  a  single  dose, 
have  frequently  occasioned  death.  True,  many  persons  can  bear,  without 
dying,  and  without  appreciable  stupor,  many  times  the  quantity  that  Mr. 
Greeley  is  reputed  to  have  taken.  But  in  his  condition  of  extreme  nervous 
prostration,  a  small  dose  of  an  extremely  depressing  medicine  mav  have 
had  a  great  effect. 

Dr.  Hammond  thought  the  treatment  should  have  been  just  the  reverse 
— stimulation.  The  celebrated  Dr.  Brown -Sequard,  from  Paris,  who  didn't 
"cure  the  Hon.  Charles  Sumner,"  thought  Mr.  Greeley  had  "paralysis  of 
the  base  and  top  brain."  Dr.  Hammond  said  this  could  not  possibly  have 
been  the  case  ;  and  in  his  opinion  the  disease  was  just  the  opposite — "in- 
flammation of  the  membranes  and  cortical  substance. "    Dr.  Brown-Sequard 


i6o 


APPENDIX. 


said  that  one  side  of  Mr.  Greeley  was  paralyzed.  Dr.  Hammond  states 
that  this  was  not  the  case.  Dr  Choate,  who  had  the  patient  m  lbs  house 
for  several  days,  refuses  to  say  anything  abo^t  the  manner  in  which  he 
treated  him.  Dr.  Brown,  of  Bloomingdale  Asylum,  refused  to  tell  the  Sun 
reporter  anything  definite.  And  is  this  all  the  people  are  to  know  of  Mr. 
Greeley's  sickness  and  treatment  from  his  five  physicians  ?  Perhaps  it  is 
none  of  the  people's  business  Possibly  it  may  be  altogether  a  private  affair 
between  the  disagreeing  doctors  and  the  unfortunate  patient  But  the  cir- 
cumstances are  vividly  suggestive  of  the  inquiry,  whether  society  exists  for 
the  benefit  of  the  medical  profession,  or  whether  the  medical  profession 
should  exist  for  the  benefit  of  society  ? 

There  is  one  other  view  of  this  case  which  concerns  all  persons  who  are 
liable  to  fall  into  the  hands  of  die  physicians.  It  is  the  usual,  almost  uni- 
versal practice  of  the  medical  profession,  to  give  persons  in  Mr.  Greeley's 
condition,  and  all  patients  who  are  feeble  or  prostrated,  alcoholic  stimulants. 
Indeed,  stimulation  and  alcohol  have  come  to  be  very  nearly  correlative 
terms.  Dr  Hammond  thought  stimulants  should  have  been  administered 
to  Mr  Greeley  instead  of  bromide  of  potassium.  Perhaps  they  were  by  the 
other  physicians,  who  keep  their  own  secrets  Be  this  as  it  may,  there  is  a 
fatal  delusion  abroad  on  this  subject  of  alcoholic  medication  To  Mr. 
Greeley  it  was  of  no  sort  of  consequence  whether  he  took  the  recognized 
stimulant  or  the  admitted  depressant.  Each  is  equally  life  exhausting. 
The  stimulation  of  alcohol  is  nothing  more  nor  less  than  a  feverish  disturb- 
ance, which  has  been  mistaken  for  "supporting  vitality."  Alcoholic 
medicines  are  almost  universally  prescribed,  because  they  augment  the  heat 
of  the  body  and  increase  the  circulation  of  the  blood.  But  the  truth  is, 
they  do  not  do  it.  They  simply  occasion  a  disturbance  of  circulation  and 
temperature,  and  so  does  bromide  of  potassium.  After  a  dose  of  alcohol 
some  parts  of  the  body  will  be  warmer  and  others  colder  (as  in  all  fevers), 
and  some  organs  will  have  more  circulation  and  others  less  (as  in  all  fevers 
also).  But  the  sum  total  of  circulation  and  temperature  is  actually  dimin- 
ished, as  in  all  febrile  diseases.  It  is  time  this  matter  was  understood  by 
physicians,  and  they  would  understand  it  if  they  would  look  at  the  facts  on 
>  record  without  prejudice.  Dr.  B.  VV.  Richardson,  of  London,  has  demon- 
strated, by  a  series  of  careful  and  elaborate  experiments,  that  all  forms  of 
alcoholic  liquors  are  just  the  reverse  of  stimulants,  so  far  as  the  whole  force 
of  the  circulation,  and  the  whole  amount  of  animal  temperature  are  con- 
cerned. Directly  or  indirectly  they  waste  vital  power,  as  every  other  poi- 
son does,  whether  the  person  who  swallows  it  is  sick  or  well.  Hygienic 
physicians  never  administer  stimulants  m  cases  of  debility,  prostration,  or 
u  running  down  "  after  fevers,  and  that  is  one  of  the  principal  reasons  why 
their  patients  so  geneially  recover. 


